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Maxillofacial obstructive sleep apnea

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...
December 18, 2016: 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
Linda Sharples, Matthew Glover, Abigail Clutterbuck-James, Maxine Bennett, Jake Jordan, Rebecca Chadwick, Marcus Pittman, Clare East, Malcolm Cameron, Mike Davies, Nick Oscroft, Ian Smith, Mary Morrell, Julia Fox-Rushby, Timothy Quinnell
BACKGROUND: Obstructive sleep apnoea-hypopnoea (OSAH) causes excessive daytime sleepiness (EDS), impairs quality of life (QoL) and increases cardiovascular disease and road traffic accident risks. Continuous positive airway pressure (CPAP) treatment is clinically effective but undermined by intolerance, and its cost-effectiveness is borderline in milder cases. Mandibular advancement devices (MADs) are another option, but evidence is lacking regarding their clinical effectiveness and cost-effectiveness in milder disease...
October 2014: Health Technology Assessment: HTA
Shofiq Islam, Uthaya Selbong, Christopher J Taylor, Ian W Ormiston
The Mallampati airway classification has been used to estimate the success of uvulopalatopharyngoplasty in patients with obstructive sleep apnoea (OSA) but its predictive value in maxillomandibular advancement has not been proved. We aimed to explore the association between preoperative Mallampati scores and surgical outcome after bimaxillary advancement for OSA. We retrospectively analysed data on 50 patients who had maxillofacial operations for OSA at our hospital and stratified them into two groups based on Mallampati scores: high (class III/IV) and low (class I/II)...
January 2015: British Journal of Oral & Maxillofacial Surgery
Mark G Hans, Matilde da Cunha Gonçalves Nojima
It is a great honor to conduct an interview with Professor Mark G. Hans, after following his outstanding work ahead of the Bolton-Brush Growth Study Center and the Department of Orthodontics at the prestigious Case Western Reserve School of Dental Medicine (CWRU) in Cleveland, Ohio. Born in Berea, Ohio, Professor Mark Hans attended Yale University in New Haven, CT, and earned his Bachelor of Science Degree in Chemistry. Upon graduation, Dr. Hans received his DDS and Masters Degree of Science in Dentistry with specialty certification in Orthodontics at Case Western Reserve University...
May 2014: Dental Press Journal of Orthodontics
Keiko Maeda, Satoru Tsuiki, Seiichi Nakata, Kenji Suzuki, Eiki Itoh, Yuichi Inoue
STUDY OBJECTIVES: Pediatric obstructive sleep apnea (OSA) is frequently associated with adenotonsillar hypertrophy, and the fact that about 30% of affected children continue to show OSA after adenotonsillectomy (AT) suggests the presence of some other predisposing factor(s). We hypothesized that abnormal maxillofacial morphology may be a predisposing factor for residual OSA in pediatric patients. METHODS: A total of 13 pediatric OSA patients (9 boys and 4 girls, age [median (interquartile range)] = 4...
September 15, 2014: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Shofiq Islam, Nosa Uwadiae, Ian W Ormiston
In the United Kingdom, maxillofacial techniques are underused in the treatment of obstructive sleep apnoea (OSA). We retrospectively analysed the details and relevant clinical data of consecutive patients who had operations for OSA at the maxillofacial unit in Leicester between 2002 and 2012. They had been referred from the local sleep clinic after investigation and diagnosis, and in all cases treatment with continuous positive airway pressure (CPAP) had failed. We compared preoperative and postoperative apnoea/hypopnoea indices (AHI), scores for the Epworth sleepiness scale (ESS), and lowest oxygen saturation to measure surgical success (AHI of less than 15 and a 50% reduction in the number of apnoeas or hypopnoea/hour) and surgical cure (AHI of less than 5)...
July 2014: British Journal of Oral & Maxillofacial Surgery
Bhik T Kotecha, Andy C Hall
A surgical approach to treatment of obstructive sleep apnoea (OSA) remains an area of intense debate, both within and without the surgical community itself. Continuous positive airway pressure (CPAP) therapy remains the gold standard for the treatment of OSA, however surgery may be indicated to facilitate CPAP and/or improve compliance in cases where CPAP is poorly tolerated. This article summarises the current range of surgical treatment options together with the evidence base for their intervention in otolaryngology, maxillofacial and bariatric surgery...
October 2014: Sleep Medicine Reviews
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