Jose Abdullatif1, Victor Certal2, Soroush Zaghi3, Sungjin A Song4, Edward T Chang4, M Boyd Gillespie5, Macario Camacho6. 1. Department of Otorhinolaryngology, Hospital Bernardino Rivadavia, Buenos Aires, Argentina. 2. Department of Otorhinolaryngology, Sleep Medicine Centre, Hospital CUF, Porto, Portugal; CINTESIS - Centre for Research in Health Technologies and Information Systems, University of Porto, Porto, Portugal. 3. Department of Otolaryngology - Head and Neck Surgery, Division of Sleep Surgery, Stanford Hospital and Clinics, Stanford, CA 95304, USA. 4. Otolaryngology - Head and Neck Surgery, Tripler Army Medical Center, Honolulu, HI, USA. 5. Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA. 6. Otolaryngology - Head and Neck Surgery, Division of Sleep Surgery and Medicine, Tripler Army Medical Center, 1 Jarrett White Road, Honolulu, HI 96859, USA; Department of Psychiatry and Behavioral Sciences, Sleep Medicine Division, Stanford Hospital and Clinics, Stanford, CA 95304, USA. Electronic address: drcamachoent@yahoo.com.
Abstract
OBJECTIVE: This study sought to systematically review the international literature for articles evaluating maxillary expansion and maxillomandibular expansion as treatments for obstructive sleep apnea (OSA) in adults and to perform a meta-analysis. DATA SOURCES: Nine databases (including MEDLINE/PubMed). REVIEW METHODS: Searches were performed through January 8, 2016. The PRISMA statement was followed. RESULTS: Eight adult studies (39 patients) reported polysomnography and/or sleepiness outcomes. Six studies reported outcomes for maxillary expansion (36 patients), and the apnea-hypopnea index (AHI) decreased from a mean (M) ± standard deviation (SD) of 24.3 ± 27.5 [95% CI 15.3, 33.3] to 9.9 ± 13.7 [95% CI 5.4, 14.4] events/hr (relative reduction: 59.3%). Maxillary expansion improved lowest oxygen saturation (LSAT) from a M ± SD of 84.3 ± 8.1% [95% CI 81.7, 87.0] to 86.9 ± 5.6% [95% CI 85.1, 88.7]. Maxillomandibular expansion was reported in two studies (3 patients) and AHI decreased from a M ± SD of 47.53 ± 29.81 [95% CI -26.5 to 121.5] to 10.7 ± 3.2 [95% CI 2.8, 18.6] events/hr (relative reduction: 77.5%). Maxillomandibular expansion improved LSAT from a M ± SD of 76.7 ± 14.5% [95% CI 40.7, 112.7] to 89.3 ± 3.1 [95% CI 81.6, 97]. CONCLUSION: The current literature demonstrates that maxillary expansion can improve and maxillomandibular expansion can possibly improve AHI and LSAT in adults; however, given the paucity of studies, these remain open for additional research efforts.
OBJECTIVE: This study sought to systematically review the international literature for articles evaluating maxillary expansion and maxillomandibular expansion as treatments for obstructive sleep apnea (OSA) in adults and to perform a meta-analysis. DATA SOURCES: Nine databases (including MEDLINE/PubMed). REVIEW METHODS: Searches were performed through January 8, 2016. The PRISMA statement was followed. RESULTS: Eight adult studies (39 patients) reported polysomnography and/or sleepiness outcomes. Six studies reported outcomes for maxillary expansion (36 patients), and the apnea-hypopnea index (AHI) decreased from a mean (M) ± standard deviation (SD) of 24.3 ± 27.5 [95% CI 15.3, 33.3] to 9.9 ± 13.7 [95% CI 5.4, 14.4] events/hr (relative reduction: 59.3%). Maxillary expansion improved lowest oxygen saturation (LSAT) from a M ± SD of 84.3 ± 8.1% [95% CI 81.7, 87.0] to 86.9 ± 5.6% [95% CI 85.1, 88.7]. Maxillomandibular expansion was reported in two studies (3 patients) and AHI decreased from a M ± SD of 47.53 ± 29.81 [95% CI -26.5 to 121.5] to 10.7 ± 3.2 [95% CI 2.8, 18.6] events/hr (relative reduction: 77.5%). Maxillomandibular expansion improved LSAT from a M ± SD of 76.7 ± 14.5% [95% CI 40.7, 112.7] to 89.3 ± 3.1 [95% CI 81.6, 97]. CONCLUSION: The current literature demonstrates that maxillary expansion can improve and maxillomandibular expansion can possibly improve AHI and LSAT in adults; however, given the paucity of studies, these remain open for additional research efforts.
Authors: Macario Camacho; Christian Guilleminault; Justin M Wei; Sungjin A Song; Michael W Noller; Lauren K Reckley; Camilo Fernandez-Salvador; Soroush Zaghi Journal: Eur Arch Otorhinolaryngol Date: 2017-12-23 Impact factor: 2.503
Authors: Winfried Randerath; Jan de Lange; Jan Hedner; Jean Pierre T F Ho; Marie Marklund; Sofia Schiza; Jörg Steier; Johan Verbraecken Journal: ERJ Open Res Date: 2022-06-27
Authors: Eric Thuler; Fábio A W Rabelo; Mariane Yui; Quedayr Tominaga; Vanier Dos Santos; Sergio Samir Arap Journal: J Clin Sleep Med Date: 2021-07-01 Impact factor: 4.324