"Skeletal surgical approach in Down Syndrome with Obstructive Sleep Apnea."

Failing to address Obstructive Sleep Apnea (OSA) in Down Syndrome (DS) patients can have serious consequences, leading to increased mortality. Moreover, a notable portion of individuals find it challenging to tolerate Continuous Positive Airway Pressure (CPAP). Therefore, this study aims to share our experiences in treating adult DS patients with moderate to severe OSA who don't tolerate CPAP using various surgical approaches. A retrospective analytical study including 20 DS with moderate to severe/very severe OSA who had no tolerance to Continuous Positive Airway Pressure (CPAP) was conducted. Regarding the individual skeletal characteristics of each patient various orthognathic surgery techniques were performed. Two in-hospital polysomnographies (PSG) were undertaken for every patient; one before the surgical procedure, while another was performed between 6 and 60 months of the follow-up post-surgery period. Polysomnographic variables were analyzed in this study such as AHI, ODI, and T90, which all showed statistically significant improvement after surgery with a p value in the Wilcoxon test <0,01. These results have remained stable over time, with no recurrences of OSA observed over the five years of follow-up. Thus, orthognathic surgery may be the only viable option for individuals with DS who are unable to tolerate CPAP.