scholarly journals Objective and Subjective Outcomes Following Maxillomandibular Advancement Surgery for Treatment of Patients With Extremely Severe Obstructive Sleep Apnea (Apnea-Hypopnea Index >100)

2016 ◽  
Vol 74 (3) ◽  
pp. 583-589 ◽  
Author(s):  
Reginald H. Goodday ◽  
Susan E. Bourque ◽  
Pember B. Edwards
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Apnea Hypopnea Index ◽  
Severe Obstructive Sleep Apnea ◽  
Maxillomandibular Advancement ◽  
Obstructive Sleep ◽  
Subjective Outcomes

Long-term Results for Maxillomandibular Advancement to Treat Obstructive Sleep Apnea: A Meta-analysis

2019 ◽  
Vol 160 (4) ◽  
pp. 580-593 ◽  
Author(s):  
Macario Camacho ◽  
Michael W. Noller ◽  
Michael Del Do ◽  
Justin M. Wei ◽  
Christopher J. Gouveia ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Oxygen Saturation ◽  
Long Term Results ◽  
Cochrane Library ◽  
Apnea Hypopnea Index ◽  
International Literature ◽  
Maxillomandibular Advancement ◽  
Obstructive Sleep

Objective To examine outcomes in the intermediate term (1 to <4 years), long term (4 to <8 years), and very long term (≥8 years) for maxillomandibular advancement (MMA) as treatment for obstructive sleep apnea (OSA). Data Sources The Cochrane Library, Google Scholar, Embase, Cumulative Index to Nursing and Allied Health, and PubMed/MEDLINE. Review Methods Three authors systematically reviewed the international literature through July 26, 2018. Results A total of 445 studies were screened, and 6 met criteria (120 patients). Thirty-one patients showed a reduction in apnea-hypopnea index (AHI) from a mean 48.3 events/h (95% CI, 42.1-54.5) pre-MMA to 8.4 (95% CI 5.6, 11.2) in the intermediate term. Fifty-four patients showed a reduction in AHI from a mean 65.8 events/h (95% CI, 58.8-72.8) pre-MMA to 7.7 (95% CI 5.9, 9.5) in the long term. Thirty-five showed a reduction in AHI from a mean 53.2 events/h (95% CI 45, 61.4) pre-MMA to 23.1 (95% CI 16.3, 29.9) in the very long term. Improvement in sleepiness was maintained at all follow-up periods. Lowest oxygen saturation improvement was maintained in the long term. Conclusion The current international literature shows that patients with OSA who were treated with MMA maintained improvements in AHI, sleepiness, and lowest oxygen saturation in the long term; however, the mean AHI increased to moderate OSA in the very long term. Definitive generalizations cannot be made, and additional research providing individual patient data for the intermediate term, long term, and very long term is needed.

MAXILLOMANDIBULAR ADVANCEMENT IN THE TREATMENT OF SEVERE OBSTRUCTIVE SLEEP APNEA HYPOPNEA SYNDROME: A CASE REPORT

2020 ◽  
Vol 130 (3) ◽  
pp. e167
Author(s):  
MARK JON SANTANA SABEY ◽  
FÁBIO RICARDO LOUREIRO SATO ◽  
DANILO DE PAULA RIBEIRO BORGES ◽  
MARCOS ANTÔNIO LIMA DOS SANTOS ◽  
LUCAS CELESTINO GUERZET AYRES ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Case Report ◽  
Sleep Apnea ◽  
Severe Obstructive Sleep Apnea ◽  
Maxillomandibular Advancement ◽  
Obstructive Sleep ◽  
Hypopnea Syndrome

scholarly journals Multilevel Surgery in Moderate to Severe Obstructive Sleep Apnea Patients

2014 ◽  
Vol 6 (3) ◽  
pp. 87-91
Author(s):  
Jumroon Tungkeeratichai ◽  
Navarat Apirakkittikul ◽  
Somyos Kunachak
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Wound Dehiscence ◽  
Velopharyngeal Insufficiency ◽  
Apnea Hypopnea Index ◽  
Severe Obstructive Sleep Apnea ◽  
Multilevel Surgery ◽  
Obstructive Sleep ◽  
Lateral Pharyngoplasty ◽  
Results Of Surgery

ABSTRACT Objective The aim of this study was to investigate the objective and subjective effectiveness of multilevel surgery, i.e. combined lingualplasty with new technique of partial posterior glossectomy (PPG) and uvulopalatopharyngoplasty in moderate to severe obstructive sleep apnea (OSA) patients. Study design and setting Retrospective study of 60 OSA patients undergoing multilevel surgery for the treatment of moderate to severe OSA. Results Preoperative mean apnea hypopnea index (AHI) was 57.5 events/h and preoperative mean lowest SpO2 was 79.1%. After multilevel surgery, postoperative mean AHI significantly decreased to 29.7 events/h (p < 0.001) and postoperative mean lowest SpO2 increased to 84.4% (p < 0.001). Patients had postoperative followup assessments for 1 to 3 years. Results of surgery was classified as curative in 35/60 (58.3%) of patients, and as effective, i.e. postoperative AHI less than preoperative AHI in 52/60 patients (86.7 %). Surgery was ineffective in 8/60 (13.3%) patients. Early postoperative complications comprised early velopharyngeal insufficiency (VPI) 20% (12/60), dysarthria 20% (12/60) and wound dehiscence 3.33% (2/60) but without serious complications after 1 year. Conclusion Combined lingualplasty (with new PPG) and uvulopalatopharyngoplasty (UPPP) as multilevel surgery can be an effective treatment of choice for patients with moderate to severe OSA. No mediumterm serious complication was found. Keywords Apnea hypopnea index, Glossectomy, Lateral pharyngoplasty, Multilevel surgery in obstructive sleep apnea, Obstructive sleep apnea, Uvulopalatoplasty. How to cite this article Tungkeeratichai J, Apirakkittikul N, Kunachak S. Multilevel Surgery in Moderate to Severe Obstructive Sleep Apnea Patients. Int J Otorhinolaryngol Clin 2014;6(3):8791.

scholarly journals Shifting and reducing breathing disturbance in patients with very severe obstructive sleep apnea by modified Z-palatoplasty with one-layer closure in one-stage multilevel surgery

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ethan I. Huang ◽  
Yu-Ching Lin ◽  
Shu-Yi Huang ◽  
Chin-Kuo Lin ◽  
Chieh-Mo Lin
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Positive Airway Pressure ◽  
Poor Response ◽  
Apnea Hypopnea Index ◽  
Severe Obstructive Sleep Apnea ◽  
One Stage ◽  
Multilevel Surgery ◽  
Obstructive Sleep ◽  
Multi Level

AbstractVery severe obstructive sleep apnea (OSA) with apnea–hypopnea index (AHI) ≥ 60 events/h differs in several areas from OSA with other severities, including having a low-level daytime partial pressure of oxygen and residual on-CPAP (continuous positive airway pressure) AHIs greater than 20/h. Patients with very severe OSA show narrow retroglossal space and confined framework, which is difficult to be enlarged via conventional Uvulopalatopharyngoplasty (UPPP) surgery, resulting in poor response to non-framework surgeries. Our latest report showed efficacy and efficiency for subjects undergoing modified Z-palatoplasty (ZPP) with one-layer closure in a one-stage multilevel surgery. It is unclear whether and how this procedure could help patients with very severe OSA characterized with confined framework. From Mar. 2015 to May 2018, we enrolled 12 patients with very severe OSA receiving one-stage multi-level surgery with modified ZPP with one-layer closure, CO2 laser partial tongue-base glossectomy, and bilateral septomeatoplasty. Our results show that the surgery reduced AHI from 73.8 ± 10.7 to 30.8 ± 23.2 events/h and achieved a mean AHI reduction of 58.3% (p < 0.001 against 0 reduction or no surgery). The surgery shifted components of the breathing disturbances. It reduced more apnea than hypopnea and might convert some apnea to hypopnea.

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