Tanner J. Diemer MS, BS, Douglas P. Nanu BS, Shaun A. Nguyen MD, Badr Ibrahim MD, Ted A. Meyer MD, PhD, Mohamed Abdelwahab MD, PhD
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引用次数: 0
Abstract
Objective
To systematically review polysomnographic and cephalometric data in obstructive sleep apnea (OSA) patients with obesity (body mass index [BMI] ≥30 kg/m2) treated with maxillomandibular advancement (MMA).
Data Sources
Scopus, PubMed, CINAHL, and The COCHRANE Library.
Review Methods
A search was performed from inception until April 3, 2024, in each database.
Results
A total of 14 studies (143 subjects) were included. The mean age was 44.3 years (range: 17–69), 80.2% males (95% CI: 72.5–86.5), mean BMI of 35.3 (95% CI: 33.1–37.5), and mean duration to follow-up post-MMA was 13.7 months (95% CI: 10.1–17.3). All objective outcomes improved significantly; overall, apnea-hypopnea index (AHI) decreased by −57.3 ([95% CI: −71.5 to −43.2], p < 0.0001) lowest oxygen saturation (LSAT) increased by 14.1% ([95% CI: 9.9 to 18.3], p < 0.0001), and Epworth Sleepiness Scale (ESS) decreased by −9.4 ([95% CI: −13.5 to −5.2], p < 0.0001). Surgical cure was 39.2% (95% CI: 20.3–60.0), and surgical success was 85.6% (95% CI: 77.8–91.5). Comparing percent reduction in class 3 obesity (−92.9%) as compared to class 1 (−85.5%) and class 2 (−83.6%) exhibited a significant difference (1 vs 3 p = 0.0012, 2 vs 3 p = 0.015).
Conclusions
Our findings suggest that MMA significantly improves subjective and objective outcomes in OSA amongst patients with obesity with results comparable to the overall population. Success rates remained above 80% in studies with the highest mean BMI. In addition, patients with class 3 obesity yielded a significantly increased benefit based on percent reduction in AHI compared with class 1 and 2.
期刊介绍：
The Laryngoscope has been the leading source of information on advances in the diagnosis and treatment of head and neck disorders since 1890. The Laryngoscope is the first choice among otolaryngologists for publication of their important findings and techniques. Each monthly issue of The Laryngoscope features peer-reviewed medical, clinical, and research contributions in general otolaryngology, allergy/rhinology, otology/neurotology, laryngology/bronchoesophagology, head and neck surgery, sleep medicine, pediatric otolaryngology, facial plastics and reconstructive surgery, oncology, and communicative disorders. Contributions include papers and posters presented at the Annual and Section Meetings of the Triological Society, as well as independent papers, "How I Do It", "Triological Best Practice" articles, and contemporary reviews. Theses authored by the Triological Society’s new Fellows as well as papers presented at meetings of the American Laryngological Association are published in The Laryngoscope.
• Broncho-esophagology
• Communicative disorders
• Head and neck surgery
• Plastic and reconstructive facial surgery
• Oncology
• Speech and hearing defects
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