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Segmental mandibular advancement for moderate-to-severe obstructive sleep apnoea: a pilot study
Y Y Leung1, J C C Wan1, H L Fu1
1Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong.
International Journal of Oral and Maxillofacial Surgery
|December 2, 2022
Summary
Segmental mandibular advancement (SMA) surgery significantly improved breathing in obstructive sleep apnoea (OSA) patients. This surgical technique for moderate-to-severe OSA demonstrated high success rates and minimal complications.
Area of Science:
- Oral and Maxillofacial Surgery
- Sleep Medicine
- Respiratory Medicine
Background:
- Obstructive sleep apnoea (OSA) is a common respiratory disorder characterized by repeated episodes of airway obstruction during sleep.
- Moderate-to-severe OSA often requires advanced treatment strategies, including surgical interventions to address tongue base obstruction.
- Segmental mandibular advancement (SMA) is a surgical technique designed for significant mandibular advancement to improve airway patency.
Purpose of the Study:
- To evaluate the surgical outcomes and complication rates of Segmental mandibular advancement (SMA) in patients with moderate-to-severe obstructive sleep apnoea (OSA).
- To assess the efficacy of SMA in improving respiratory parameters and airway dimensions in OSA patients.
Main Methods:
- A pilot study involving twelve patients (nine male, three female) diagnosed with moderate-to-severe OSA.
- Patients underwent Segmental mandibular advancement (SMA) as part or the entirety of their skeletal advancement procedure.
- Surgical outcomes were assessed by monitoring the apnoea-hypopnoea index (AHI), lowest oxygen saturation (LSAT), and airway volume changes one year postoperatively.
Main Results:
- The apnoea-hypopnoea index (AHI) decreased from a mean of 42.4/hour preoperatively to 9.0/hour at one year postoperative.
- Surgical success, defined as a 50% reduction in AHI, was achieved in 91.7% of patients, with 58.3% achieving surgical cure (AHI<5/hour).
- Airway volume significantly increased from 2.4 cm³ to 6.7 cm³ (P < 0.001), and lowest oxygen saturation improved from 73.3% to 78.7%.
Conclusions:
- Segmental mandibular advancement (SMA) appears to be a safe and effective surgical option for managing moderate-to-severe obstructive sleep apnoea (OSA).
- The procedure leads to significant improvements in respiratory function and airway dimensions with a low incidence of major complications.
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