Ana Celia Faria1,2, Luis Vicente Garcia3, Antonio Carlos Santos4, Alan Luiz Eckeli5, Denny Marcos Garcia6,7, Francisco Verissimo Mello-Filho6,7. 1. Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, University of São Paulo, Ribeirão Preto, SP, Brazil. anacfaria@usp.br. 2. Faculty of Medicine of Ribeirão Preto, University of São Paulo, Av. Bandeirantes, 3900, 14049-900, Ribeirão Preto, SP, Brazil. anacfaria@usp.br. 3. Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, University of São Paulo, Ribeirão Preto, SP, Brazil. 4. Center of Imaging Sciences and Medical Physics, University of São Paulo, Ribeirão Preto, SP, Brazil. 5. Department of Neurology, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil. 6. Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, University of São Paulo, Ribeirão Preto, SP, Brazil. 7. Craniofacial Research Support Center, University of São Paulo, Ribeirão Preto, SP, Brazil.
Abstract
PURPOSE: To compare the dynamic differences occurring in the pharynx during sleep after maxillomandibular advancement (MMA) surgery for the treatment of patients with obstructive sleep apnea syndrome. METHODS: This was a prospective, cross-sectional study conducted on 20 patients (15 men and 5 women) with a polysomnography diagnosis of obstructive sleep apnea (OSA) submitted to surgical treatment with MMA. All patients were submitted to magnetic resonance (MR) during propofol-induced sleep before and 6 months after surgery. Thirty linear measurements (30 sections) were obtained over time in the retrolingual (RL) region to compare their variability before and after MMA. RESULTS: The mean linear anteroposterior increase of the pharynx during induced sleep after MMA was 66 % in the RL region (P < 0.01). The coefficient of variation of the linear measurements was 117.5 % before surgery, being reduced to 51 % after surgery. CONCLUSIONS: MMA promoted an important increase of the pharynx during induced sleep and a more significant change in the variability of its lumen. With a lower variation in the diameter of the organ during the respiratory movements, there is greater airway stability and a consequent maintenance of the pharyngeal lumen that reduces or even prevents pharyngeal collapse.
PURPOSE: To compare the dynamic differences occurring in the pharynx during sleep after maxillomandibular advancement (MMA) surgery for the treatment of patients with obstructive sleep apnea syndrome. METHODS: This was a prospective, cross-sectional study conducted on 20 patients (15 men and 5 women) with a polysomnography diagnosis of obstructive sleep apnea (OSA) submitted to surgical treatment with MMA. All patients were submitted to magnetic resonance (MR) during propofol-induced sleep before and 6 months after surgery. Thirty linear measurements (30 sections) were obtained over time in the retrolingual (RL) region to compare their variability before and after MMA. RESULTS: The mean linear anteroposterior increase of the pharynx during induced sleep after MMA was 66 % in the RL region (P < 0.01). The coefficient of variation of the linear measurements was 117.5 % before surgery, being reduced to 51 % after surgery. CONCLUSIONS:MMA promoted an important increase of the pharynx during induced sleep and a more significant change in the variability of its lumen. With a lower variation in the diameter of the organ during the respiratory movements, there is greater airway stability and a consequent maintenance of the pharyngeal lumen that reduces or even prevents pharyngeal collapse.
Authors: T Hori; Y Sugita; E Koga; S Shirakawa; K Inoue; S Uchida; H Kuwahara; M Kousaka; T Kobayashi; Y Tsuji; M Terashima; K Fukuda; N Fukuda Journal: Psychiatry Clin Neurosci Date: 2001-06 Impact factor: 5.188
Authors: Lane F Donnelly; Victoria Surdulescu; Barbara A Chini; Keith A Casper; Stacy A Poe; Raouf S Amin Journal: Radiology Date: 2003-02-28 Impact factor: 11.105