A retrospective controlled study on the treatment effect of distraction osteogenesis and maxillomandibular advancement for severe obstructive sleep apnea hypopnea syndrome patients.
10.3760/cma.j.cn112144-20220127-00033
- VernacularTitle:牵张成骨术与双颌前徙术治疗阻塞性睡眠呼吸暂停低通气综合征的临床回顾性对照研究
- Author:
Yu Fan ZHANG
1
;
Zhi Ru ZHANG
1
;
Zhi Jun TAN
2
;
Bo YU
1
;
Tai Qiang DAI
1
;
Fu Wei LIU
3
;
Liang KONG
3
;
Lei TIAN
1
;
Bo Lei CAI
1
Author Information
1. Department of Maxillofacial Trauma and Orthognathic Surgery, School of Stomatology, The Fourth Military Medical University & State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Xi'an 710032, China.
2. Department of Health Statistics, Military Preventive Medical College, Forth Military Medical University, Xi'an 710032, China.
3. Department of Craniofacial Plastic and Aesthetic Surgery, School of Stomatology, Forth Military Medical University & State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Xi'an 710032, China.
- Publication Type:Journal Article
- MeSH:
Humans;
Mandibular Advancement;
Osteogenesis, Distraction;
Retrospective Studies;
Sleep Apnea, Obstructive/surgery*;
Treatment Outcome
- From:
Chinese Journal of Stomatology
2022;57(9):907-913
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To compare the treatment effect of distraction osteogenesis (DO) and maxillomandibular advancement (MMA) for severe obstructive sleep apnea hypopnea syndrome (OSAHS) patients and to guide clinical decisions about treatment of OSAHS. Methods: Thirty-seven OSAHS patients which accepted maxillomandibular advancement (MMA) or distraction osteogenesis (DO) in Stomatological Hospital of the Department of Maxillofacial Trauma and Orthognathic Surgery, School of Stomatology, The Forth Military Medical University from June 2017 to June 2019 were collected. Their preoperative and postoperative data of cephalometry, polysomnography (PSG), Pittsburgh sleep quality index (PSQI) and Epworth sleepiness scale (ESS) scores were collected and analyzed. With propensity score matching method, the treatment effect of MMA and DO was analyzed and compared. Results: According to the statistics of MMA group, only AHI was correlated with operative successful rate and cure rate. With the increase of AHI, the treatment effect of MMA on OSAHS patients gradually decreased. The cut-off point of AHI as a predictor of MMA treatment failure was 78.2 n/h. All the matched cases were severe OSAHS patients. Statistical analysis showed that the mandibular elongation of DO patients[(24.00±4.39) mm] was significantly more than that of MMA group [(11.20±1.37) mm] (t=-6.11, P<0.001), the improvement of PSG index [including lowest oxygen saturation (LSpO2), longest apnea (LA) and longest hypopnea (LH)] in DO group [LSpO2=(93.40±1.82)%; LA=(18.28±8.32) s; LH=(61.84±32.94) s] was significantly higher than that in the MMA group [LSpO2=(86.00±4.06)%, LA=(64.08±21.78) s, LH=(172.40±30.70) s](t=-3.72, P=0.005; t=4.39, P=0.003; t=5.49, P=0.004). The PSQI and the ESS scores of DO group (PSQI=4.20±0.83; ESS=3.40±1.52) were also significantly better than that of MMA group (PSQI=8.80±2.39, ESS=9.40±2.88)(t=4.07, P=0.001; t=4.12, P=0.002). Conclusions: For severe OSAHS patients, the objective and subjective indicators of DO treatment group showed a better therapeutic effect than that of MMA.
