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Maxillo-mandibular surgery for obstructive sleep apnoea.

C Guilleminault1, M A Quera-Salva, N B Powell

  • 1Stanford University School of Medicine, Palo Alto, California.

The European Respiratory Journal
|July 1, 1989
PubMed
Summary
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Maxillomandibular advancement surgery effectively treated obstructive sleep apnea syndrome in 18 patients. Mandibular surgery improved 32 of 36 patients, but maxillo-mandibular advancement yielded superior satisfactory outcomes.

Area of Science:

  • Oral and Maxillofacial Surgery
  • Sleep Medicine
  • Otolaryngology

Background:

  • Obstructive sleep apnea syndrome (OSAS) is a common condition.
  • Surgical interventions, including mandibular surgery, are explored for OSAS treatment.
  • Maxillomandibular advancement is a surgical option for severe OSAS.

Purpose of the Study:

  • To compare the efficacy of two surgical approaches for obstructive sleep apnea syndrome.
  • To evaluate outcomes based on pre-set criteria for procedure selection and results.
  • To identify factors influencing surgical success in OSAS treatment.

Main Methods:

  • A study involving 54 patients with OSAS undergoing surgical treatment.
  • Population A (36 patients): Palato-pharyngoplasty with inferior sagittal osteotomy and hyoid myotomy/resuspension.

Related Experiment Videos

  • Population B (18 patients): Maxillo-mandibular hyoid advancement, including palato-pharyngoplasty, mandibular osteotomy, and subsequent maxillo-mandibular osteotomy.

    • Main Results:

    • Population A: 32/36 patients showed improvement, with 20/36 considered satisfactory outcomes.
    • Population B: All 18 patients achieved satisfactory outcomes.
    • Both surgical approaches demonstrated good polygraphic results, with nasal CPAP use prior to surgery in four Population B patients showing comparable efficacy.

    Conclusions:

    • Maxillo-mandibular hyoid advancement demonstrated superior satisfactory outcomes compared to standard mandibular surgery for OSAS.
    • Skeletal craniofacial deficiencies, especially retrognathia, are critical factors in selecting the appropriate surgical procedure.
    • Understanding procedural risks and potential complications is essential for patient management.