Diego Sergio Rossi1, Michele Romano2, Ahmed Hassan Sweed3, Alessandro Baj2, Aldo Bruno Gianni2, Giada Anna Beltramini1. 1. Dental and Maxillo-Facial Surgery Unit, IRCCS Ca Granda Ospedale Maggiore Policlinico di Milano, Via Francesco Sforza 35, Milan, Italy. 2. Dental and Maxillo-Facial Surgery Unit, IRCCS Ca Granda Ospedale Maggiore Policlinico di Milano, Via Francesco Sforza 35, Milan, Italy; Department of Biomedical, Surgical and Dental Sciences, University of Milan, Italy. 3. Dental and Maxillo-Facial Surgery Unit, IRCCS Ca Granda Ospedale Maggiore Policlinico di Milano, Via Francesco Sforza 35, Milan, Italy; ORL-HNS, Zagazig University, Faculty of Medicine, Egypt. Electronic address: dr.orl.sweed@gmail.com.
Abstract
INTRODUCTION: Although multilevel surgery is the mainstay treatment for severe obstructive sleep apnoea syndrome (OSAS), bi-maxillary surgery (maxillomandibular advancement [MMA]) is the most efficacious single procedure for the expansion of the whole pharyngeal airway. MMA is an alternative to the gold standard of continuous positive airway pressure and is equivalent to tracheotomy. PATIENTS AND METHOD: Computer-aided design/computer-aided manufacturing (CAD-CAM) technology was used to virtually assess the degree of mandibular and/or maxillary advancement and rotation required to obtain adequate posterior airway space (PAS) in eight patients (seven males, one female). The mean age of the patients was 45.5 years (range, 27-51 years), and the average body mass index was 28.9 kg/m2 (range, 21.9-31.8 kg/m2). RESULTS: The study group showed significant mandibular advancement, widening of the PAS, and reduction of the apnoea hypopnea index (p < 0.0001, p < 0.0001, and p < 0.0002, respectively). Moreover, patient satisfaction scores regarding postoperative facial profile changes showed excellent compliance. CONCLUSION: This study demonstrated that bi-maxillary surgery is an efficient single surgical procedure in patients with multilevel OSAS. CAD-CAM technology aided surgeons in performing this operation precisely and enabled patients to expect specific facial profiles.
INTRODUCTION: Although multilevel surgery is the mainstay treatment for severe obstructive sleep apnoea syndrome (OSAS), bi-maxillary surgery (maxillomandibular advancement [MMA]) is the most efficacious single procedure for the expansion of the whole pharyngeal airway. MMA is an alternative to the gold standard of continuous positive airway pressure and is equivalent to tracheotomy. PATIENTS AND METHOD: Computer-aided design/computer-aided manufacturing (CAD-CAM) technology was used to virtually assess the degree of mandibular and/or maxillary advancement and rotation required to obtain adequate posterior airway space (PAS) in eight patients (seven males, one female). The mean age of the patients was 45.5 years (range, 27-51 years), and the average body mass index was 28.9 kg/m2 (range, 21.9-31.8 kg/m2). RESULTS: The study group showed significant mandibular advancement, widening of the PAS, and reduction of the apnoea hypopnea index (p < 0.0001, p < 0.0001, and p < 0.0002, respectively). Moreover, patient satisfaction scores regarding postoperative facial profile changes showed excellent compliance. CONCLUSION: This study demonstrated that bi-maxillary surgery is an efficient single surgical procedure in patients with multilevel OSAS. CAD-CAM technology aided surgeons in performing this operation precisely and enabled patients to expect specific facial profiles.
Authors: Diego Sergio Rossi; Funda Goker; Federico Cullati; Alessandro Baj; Daniele Pignatelli; Aldo Bruno Gianni; Massimo Del Fabbro Journal: Int J Environ Res Public Health Date: 2022-05-21 Impact factor: 4.614