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Maxillofacial obstructive sleep apnea

Richard Ngo, Elaina Pullano, Zachary S Peacock, Edward T Lahey, Meredith August
PURPOSE: Obstructive sleep apnea (OSA) patients with retrognathia and measurable anatomic airway determinants may represent a subset of OSA patients and have distinct comorbidity profiles. Our aim was to compare the medical comorbidities of OSA patients managed surgically with maxillomandibular advancement with those of nonsurgical patients. PATIENTS AND METHODS: In this cross-sectional retrospective study, patients for both cohorts were identified through the Massachusetts General Hospital oral and maxillofacial surgery data registry and the Massachusetts General Hospital Research Patient Data Registry...
January 31, 2018: Journal of Oral and Maxillofacial Surgery
Sung Ok Hong, Yu-Feng Chen, Junho Jung, Yong-Dae Kwon, Stanley Yung Chuan Liu
The prevalence of obstructive sleep apnea (OSA) is estimated to be 1-5% of the adult population world-wide, and in Korea, it is reported at 4.5% of men and 3.2% of women (Age 40 to 69 years old). Active treatment of OSA is associated with decrease in insulin resistance, cardiovascular disease, psychosocial problems, and mortality. Surgical treatment of OSA has evolved in the era of neuromodulation with the advent of hypoglossal nerve stimulation (HGNS). We share this review of HGNS with our maxillofacial surgical colleagues to expand the scope of surgical care for OSA...
December 2017: Maxillofacial Plastic and Reconstructive Surgery
Christine Cortet-Rudelli
Orofacial changes are frequent in acromegaly. Their evolution is slowly progressive. The lips (everted and thickened), the mandibular morphology (prognathism), the tongue (macroglossia), the soft palate and the uvula (increased and thickened), the parodontis (gingival hyperplasia, paradontitis), the teeth (increased interdental spaces, hypercementosis, increased dental mobility, multiple tooth loss) are concerned. Functional consequences are significant (obstructive sleep apnea syndrome, malocclusion, pain of the oral maxillofacial area, decrease of the quality of life)...
September 2017: La Presse Médicale
C M Resnick
Mandibular distraction osteogenesis (MDO) has become the first-line operation in many centers for the management of obstructive sleep apnea (OSA) in infants with (Pierre) Robin sequence (RS) not relieved by non-surgical approaches. Preoperative virtual surgical planning (VSP) may improve precision and decrease complications for this operation. This article reports a retrospective study of RS infants who underwent MDO for OSA using preoperative VSP and three-dimensionally printed cutting guides performed by one surgeon...
January 2018: International Journal of Oral and Maxillofacial Surgery
Meriem Mastouri, Alessandro Amaddeo, Lucie Griffon, Annick Frapin, Samira Touil, Adriana Ramirez, Sonia Khirani, Brigitte Fauroux
OBJECTIVES: A significant number of children are able to discontinue long term continuous positive airway pressure (CPAP) or noninvasive ventilation (NIV) but the underlying disorders, weaning criteria, and outcome of these children have not been studied. STUDY DESIGN: Retrospective cohort follow up. SUBJECT SELECTION: Consecutive children who were weaned from long term CPAP/NIV between October 2013 and January 2016. METHODOLOGY: Underlying disorders, weaning criteria, and clinical outcome were analyzed...
October 2017: Pediatric Pulmonology
Benjamin P Geisler, Yisi D Ji, Zachary S Peacock
PURPOSE: The purpose of this study is to describe the state of economic analyses in the field of oral and maxillofacial surgery (OMS). MATERIALS AND METHODS: A systematic search of published literature up to 2016 was performed. The inclusion criteria were as follows: English-language articles on economic analyses pertaining to OMS including anesthesia and pain management; dentoalveolar surgery; orthognathic, cleft, and/or obstructive sleep apnea treatment; pathology; reconstruction; temporomandibular disorders; trauma; and other...
November 2017: Journal of Oral and Maxillofacial Surgery
Jonathan J Swope, Marcus A Couey, James W Wilson, Jonathon S Jundt
PURPOSE: Surgical treatment for obstructive sleep apnea (OSA) varies by specialty. Our survey sought to answer 3 principal questions: 1) To which surgical specialists are sleep physicians referring patients for upper airway surgery? 2) Which surgical treatment do sleep specialists find to be most effective in treating OSA? 3) Do sleep medicine physicians believe that maxillomandibular advancement (MMA) is worthwhile to patients who are surgical candidates? MATERIALS AND METHODS: We formulated a cross-sectional survey...
May 2017: Journal of Oral and Maxillofacial Surgery
Shuji Oishi, Yasuhiro Shimizu, Jun Hosomichi, Yoichiro Kuma, Hideyuki Maeda, Hisashi Nagai, Risa Usumi-Fujita, Sawa Kaneko, Naoki Shibutani, Jun-Ichi Suzuki, Ken-Ichi Yoshida, Takashi Ono
Intermittent hypoxia (IH) recapitulates morphological changes in the maxillofacial bones in children with obstructive sleep apnea (OSA). Recently, we found that IH increased bone mineral density (BMD) in the inter-radicular alveolar bone (reflecting enhanced osteogenesis) in the mandibular first molar (M1) region in the growing rats, but the underlying mechanism remains unknown. In this study, we focused on the hypoxia-inducible factor (HIF) pathway to assess the effect of IH by testing the null hypothesis of no significant differences in the mRNA-expression levels of relevant factors associated with the HIF pathway, between control rats and growing rats with IH...
2016: Frontiers in Physiology
Wenwen Yu, Meng Wang, Kan Yao, Ming Cai, Hongxia Sun, Liyan Lu, Min Zhu, Xiaofeng Lu
PURPOSE: Pediatric patients with Crouzon syndrome have great possibilities of suffering from obstructive sleep apnea (OSA), which is mainly due to midfacial hypoplasia and facial deformities. For most patients, a multidisciplinary and sequential treatment plan is necessary to make for Crouzon syndrome often has different phenotypes of different severity in OSA and facial deformities. Typical patients were selected in this paper to illustrate the necessity of individualized therapy for treating OSA...
September 2016: Sleep & Breathing, Schlaf & Atmung
Luis A Passeri, James G Choi, Leonard B Kaban, Edward T Lahey
PURPOSE: To compare morbidity and mortality rates in obstructive sleep apnea (OSA) versus dentofacial deformity (DFD) patients undergoing equivalent maxillofacial surgical procedures. PATIENTS AND METHODS: Patients with OSA who underwent maxillomandibular advancement with genial tubercle advancement in the Massachusetts General Hospital Department of Oral and Maxillofacial Surgery from December 2002 to June 2011 were matched to patients with DFD undergoing similar maxillofacial procedures during the same period...
October 2016: Journal of Oral and Maxillofacial Surgery
Luca Levrini, Franco Sacchi, Francesca Milano, Antonella Polimeni, Paolo Cozza, Edoardo Bernkopf, Marzia Segù, Marco Zucconi, Claudio Vicini, Enrico Brunello
BACKGROUND: The aim of the present article is to present a set of proposed clinical recommendations aimed at Italian dentists involved in the management of patients with obstructive sleep apnea syndrome or snoring. METHODS: With the purpose of creating a study group, some of the most important Italian scientific societies operating in fields relevant to the issue of sleep medicine in dentistry were asked to appoint a representative. Each member of the study group was required to answer questions regarding the clinical management of OSAS and snoring...
July 2015: Annali di Stomatologia
Sung Woon On, Min Woo Han, Doo Yeon Hwang, Seung Il Song
OBJECTIVES: The purpose of this study was to evaluate changes in the pharyngeal airway space and hyoid bone position after mandibular setback surgery with bilateral sagittal split ramus osteotomy (BSSRO) and to analyze the correlation between the amount of mandibular setback and the amount of change in pharyngeal airway space or hyoid bone position. MATERIALS AND METHODS: From January 2010 to February 2013, a total of 30 patients who were diagnosed with skeletal class III malocclusion and underwent the same surgery (BSSRO) and fixation method in the Division of Oral and Maxillofacial Surgery, Department of Dentistry at the Ajou University School of Medicine (Suwon, Korea) were included in this study...
October 2015: Journal of the Korean Association of Oral and Maxillofacial Surgeons
Nobuto Onda, Shintaro Chiba, Hiroto Moriwaki, Rika Sawai, Akira Yoshigoe, Subaru Watanabe, Yuji Ando, Ryo Uchida, Takeshi Miyawaki, Kota Wada
Apert syndrome is a congenital syndrome characterized by craniosynostosis and craniofacial dysostosis, among other features, and is reported to cause obstructive sleep apnea (OSA) because of upper airway narrowing associated with midfacial dysplasia. We recently encountered a case involving a patient with Apert syndrome complicated by OSA who began to receive continuous positive airway pressure (CPAP) therapy at the age of 4. OSA resolved after maxillofacial surgery performed at the age of 11, and CPAP was eventually withdrawn...
2015: Case Reports in Otolaryngology
João Vitor dos Santos Canellas, Hugo Leonardo Mendes Barros, Paulo José D'Albuquerque Medeiros, Fabio Gamboa Ritto
INTRODUCTION: A mandibular setback reduces space in the pharyngeal airway, and it has been suggested that it might induce sleep-disordered breathing. OBJECTIVES: An evidence-based literature review was conducted to identify the effect of mandibular setback on the respiratory function during sleep. METHODS: The authors performed a systematic review of pertinent literature published up to 2014. A structured search of literature was performed, with predefined criteria...
March 2016: Sleep & Breathing, Schlaf & Atmung
Reginald H Goodday, Susan E Bourque, Pember B Edwards
PURPOSE: It is important for patients and treating clinicians to know whether maxillomandibular advancement (MMA) surgery is effective when treating patients with obstructive sleep apnea syndrome (OSAS) and an extremely high apnea-hypopnea index (AHI) score. The purpose of this study was to evaluate objective and subjective treatment outcomes after MMA surgery for the treatment of OSAS in patients with a preoperative AHI score higher than 100. PATIENTS AND METHODS: This retrospective study included all patients who underwent MMA surgery for OSAS by members of the Department of Oral and Maxillofacial Surgery, QEII Health Science Centre (Halifax, Nova Scotia, Canada) from November 1996 through February 2014...
March 2016: Journal of Oral and Maxillofacial Surgery
A P Huet, C Paulus
The obstructive sleep apnea syndrome (OSAS) may affect children, especially those with dentofacial disharmonies. Dentofacial orthopedic (DFO) treatments carried out in those patients must take this condition into account and can, in selected cases, improve or even treat the OSAS. The goal of our work was to report our experience about DFO treatments of children affected by OSAS in the department of maxillofacial surgery of Femme-Mère-Enfant hospital of university hospitals of Lyon, France.
September 2015: Revue de Stomatologie, de Chirurgie Maxillo-faciale et de Chirurgie Orale
Xiaofeng Lu, Min Zhu, Bing Wang
Obstructive sleep disordered breathing (USDB) is a common diseases which caused by upper airway(UA) occlusion, muscle tone problems and collapse of upper airway etc. The article introduces how to select surgical treatment protocol. First, it is necessary of PSG and upper airway evaluation. Then, it is key to master surgical indications. For the children with hypertrophy of tonsillectomy or adenoidectomy, it may first step of tonsillectomy or adenoidectomy, they needed followed up by orthodontic doctor or orthognathic surgeon for tooth and maxillomandibular malformation...
March 2015: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
Lillian Marcussen, Jan Erik Henriksen, Torben Thygesen
PURPOSE: The upper airway volume is central to the development and treatment of snoring and obstructive sleep apnea, and mandibular advancement devices (MADs) have increasingly been used as an effective alternative to continuous positive airway pressure for these 2 conditions. We investigated the changes in breathing patterns and upper airway volume parameters measured on cone-beam computed tomography (CBCT) scans of patients with and without the use of custom-made MADs. MATERIALS AND METHODS: We performed a prospective study at the Department of Oral and Maxillofacial Surgery, Odense University Hospital, on consecutively treated patients...
September 2015: Journal of Oral and Maxillofacial Surgery
Sang Hwa Lee, Leonard B Kaban, Edward T Lahey
PURPOSE: To determine the long-term stability of maxillomandibular advancement (MMA) in patients with obstructive sleep apnea (OSA). MATERIALS AND METHODS: This was a retrospective cohort study of patients who underwent MMA and genial tubercle advancement (GTA) for treatment of OSA. Patients were included if they 1) were older than 19 years; 2) had a confirmatory polysomnogram; 3) underwent a Le Fort I osteotomy, bilateral sagittal split osteotomies, and GTA; 4) had adequate radiographic documentation; and 5) at least 11 months of follow-up...
April 2015: Journal of Oral and Maxillofacial Surgery
Thorkild B Knudsen, Anne S Laulund, Janne Ingerslev, Preben Homøe, Else M Pinholt
PURPOSE: This study investigated whether patients with obstructive sleep apnea (OSA) who undergo maxillomandibular advancement (MMA) with counterclockwise (CCW) rotation compared with those who undergo MMA without CCW rotation have better outcomes. MATERIALS AND METHODS: This was a systematic review with meta-analysis. The Medline and Cochrane databases were searched for randomized controlled trials using Medical Subject Headings. The predictor variable was operative technique, namely MMA with or without CCW rotation of the maxillofacial complex...
April 2015: Journal of Oral and Maxillofacial Surgery
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