The effect of maxillomandibular advancement on the pharyngeal airway and apnea-hypopnea index in obstructive sleep apnea syndrome patients

Background: Obstructive sleep apnea syndrome (OSAS) is a common disease. The objective of this research was to determine the effectiveness of a graduated walking program in reducing the apnea–hypopnea index number in patients with obstructive sleep apnea syndrome (OSAS). Methods: A randomized controlled clinical trial with a two-arm parallel in three tertiary hospitals was carried out with seventy sedentary patients with moderate to severe OSAS. Twenty-nine subjects in each arm were analyzed by protocol. The control group received usual care, while usual care and an exercise program based on progressive walks without direct supervision for 6 months were offered to the intervention group. Results: The apnea–hypopnea index decreased by six points in the intervention group, and improvements in oxygen desaturation index, total cholesterol, and Low-Density Lipoprotein of Cholesterol (LDL-c) were observed. A higher decrease in sleep apnea–hypopnea index (45 ± 20.6 vs. 34 ± 26.3/h; p = 0.002) was found in patients with severe vs. moderate OSAS, as well as in oxygen desaturation index from baseline values (43.3 vs. 34.3/h; p = 0.046). Besides, High-Density Lipoprotein of Cholesterol (HDL-c) values showed a higher increase in the intervention group (45.3 vs. 49.5 mg/dL; p = 0.009) and also, a higher decrease in LDL-c was found in this group (141.2 vs. 127.5 mg/dL; p = 0.038). Conclusion: A home physical exercise program is a useful and viable therapeutic measure for the management of OSAS.

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Negative association between self-reported jaw symptoms and apnea–hypopnea index in patients with symptoms of obstructive sleep apnea syndrome: a pilot study

Sleep And Breathing ◽

10.1007/s11325-012-0704-4 ◽

2012 ◽

Vol 17 (1) ◽

pp. 373-379 ◽

Cited By ~ 11

Author(s):

Takafumi Kato ◽

Akira Mikami ◽

Hideko Sugita ◽

Hisae Muraki ◽

Mutsumi Okura ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Pilot Study ◽

Obstructive Sleep Apnea Syndrome ◽

Sleep Apnea Syndrome ◽

Negative Association ◽

Apnea Hypopnea Index ◽

Obstructive Sleep ◽

Apnea Syndrome

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Maxillomandibular Advancement for Obstructive Sleep Apnea Syndrome

Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.joms.2016.01.020 ◽

2016 ◽

Vol 74 (4) ◽

pp. 680-681

Author(s):

Michael Miloro

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Obstructive Sleep Apnea Syndrome ◽

Sleep Apnea Syndrome ◽

Maxillomandibular Advancement ◽

Obstructive Sleep ◽

Apnea Syndrome

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Lateral-Expansion Pharyngoplasty: Combined Technique for the Treatment of Obstructive Sleep Apnea Syndrome

International Archives of Otorhinolaryngology ◽

10.1055/s-0039-1695026 ◽

2019 ◽

Vol 24 (01) ◽

pp. e107-e111 ◽

Cited By ~ 1

Author(s):

José Antonio Pinto ◽

Luciana Balester Mello de Godoy ◽

Heloisa dos Santos Sobreira Nunes ◽

Kelly Elia Abdo ◽

Gabriella Spinola Jahic ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Obstructive Sleep Apnea Syndrome ◽

Sleep Apnea Syndrome ◽

Surgical Techniques ◽

Upper Airway ◽

Apnea Hypopnea Index ◽

Lateral Expansion ◽

Obstructive Sleep ◽

Apnea Syndrome

Abstract Introduction Obstructive sleep apnea syndrome (OSAS) is a multifactorial disease characterized by episodes of partial or complete collapse during sleep of different regions of the upper airway. Surgery for OSAS evolved with the introduction of different techniques, considering new surgical concept of reconstruction of the upper airway. Objective To retrospectively evaluate the effectiveness of a new approach aimed at reducing pharyngeal collapse by combining two surgical techniques: lateral and expansion pharyngoplasty. Methods We reviewed the medical records of 38 patients with OSAS undergoing lateral/expansion pharyngoplasty from January 2012 to December 2016. The following data were collected: patient age, gender, and pre- and postoperative body mass index (BMI), Epworth sleepiness scale (ESS) scores, snoring visual analogue scale (VAS) scores, and polysomnography (PSG) results. Results The PSG results showed a significant reduction in the apnea/hypopnea index (AHI) from 22.4 ± 27.3 events/h preoperatively to 13.6 ± 17.9 events/h postoperatively (p = 0.009), with postoperative AHI reduction greater than 50% in 63.2% of the patients. There was also a significant reduction in the microarousal index (19.5 ± 22.6 vs 11.0 ± 13.4 events/h; p = 0.001) and in the minimum oxygen saturation (82.6 ± 10.3 vs 86.9 ± 11.1; p = 0.007). Conclusions Lateral-expansion pharyngoplasty represents a new surgical strategy for the treatment of OSAS in patients with palatal collapse by combining two different techniques: lateral and expansion pharyngoplasty. The two techniques, performed as a one-stage procedure, led to improvements in excessive daytime sleepiness, snoring, and PSG respiratory parameters by acting on lateral and retropalatal collapse, producing favorable results with good applicability in otolaryngology clinical practice.

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