Kentaro Ide1, Kazuhiro Ooi2, Sayuri Takamichi3, Rei Jokaji1, Yutaka Kobayashi1, Kazuo Kasahara4, Masako Nakata3, Shuichi Kawashiri1. 1. Department of Oral and Maxillofacial Surgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8641, Japan. 2. Department of Oral and Maxillofacial Surgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8641, Japan. k-ooi@staff.kanazawa-u.ac.jp. 3. Department of Clinical Laboratory, Graduate School of Medicine, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, Japan. 4. Department of Respiratory Medicine, Graduate School of Medicine, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, Japan.
Abstract
PURPOSE: The incidence of obstructive sleep apnea (OSA) immediately after surgery in patients with dentofacial deformities without previous OSA remains unknown. We aimed to perioperatively evaluate factors associated with oxygen desaturation index (ODI) during sleep, 7 days after bilateral splitting ramus osteotomy (BSSRO) in patients without previous OSA. METHODS: Fifty-one patients (15 males, 36 females) with dentofacial deformities, scheduled to undergo BSSRO, were included. Polysomnography was performed before orthognathic surgery. Perioperative OSA was evaluated with peripheral arterial tonometry on the day of surgery and 1, 2, 3, 4, and 7 days postoperatively. Rapid eye movement (REM) sleep periods and the ODI were measured. Factors associated with perioperative ODI after surgery were statistically analyzed. RESULTS: REM sleep periods were significantly decreased on the day of surgery and significantly increased at 4 and 7 days postoperatively, compared to the preoperative period. ODI increased on the day of surgery, decreased after 1 day, and increased again at 4 and 7 days postoperatively. ODI on the day of surgery was significantly increased due to increased preoperative ODI, overjet, and SN-MP angle and decreased SNA and SNB angle. ODI at 7 days postoperatively was significantly increased due to increased REM sleep periods and decreased SN-MP and gonial angle. ODI was increased in response to REM sleep periods 7 days after BSSO. CONCLUSION: Airway management in patients with dentofacial deformity should be given more attention by preoperative assessment for OSA, even in the absence of previous OSA, until 7 days postoperatively due to REM rebound.
PURPOSE: The incidence of obstructive sleep apnea (OSA) immediately after surgery in patients with dentofacial deformities without previous OSA remains unknown. We aimed to perioperatively evaluate factors associated with oxygen desaturation index (ODI) during sleep, 7 days after bilateral splitting ramus osteotomy (BSSRO) in patients without previous OSA. METHODS: Fifty-one patients (15 males, 36 females) with dentofacial deformities, scheduled to undergo BSSRO, were included. Polysomnography was performed before orthognathic surgery. Perioperative OSA was evaluated with peripheral arterial tonometry on the day of surgery and 1, 2, 3, 4, and 7 days postoperatively. Rapid eye movement (REM) sleep periods and the ODI were measured. Factors associated with perioperative ODI after surgery were statistically analyzed. RESULTS: REM sleep periods were significantly decreased on the day of surgery and significantly increased at 4 and 7 days postoperatively, compared to the preoperative period. ODI increased on the day of surgery, decreased after 1 day, and increased again at 4 and 7 days postoperatively. ODI on the day of surgery was significantly increased due to increased preoperative ODI, overjet, and SN-MP angle and decreased SNA and SNB angle. ODI at 7 days postoperatively was significantly increased due to increased REM sleep periods and decreased SN-MP and gonial angle. ODI was increased in response to REM sleep periods 7 days after BSSO. CONCLUSION: Airway management in patients with dentofacial deformity should be given more attention by preoperative assessment for OSA, even in the absence of previous OSA, until 7 days postoperatively due to REM rebound.
Authors: Sreeya Yalamanchali; Viken Farajian; Craig Hamilton; Thomas R Pott; Christian G Samuelson; Michael Friedman Journal: JAMA Otolaryngol Head Neck Surg Date: 2013-12 Impact factor: 6.223
Authors: Timon M Fabius; Jeffrey R Benistant; Lindsey Bekkedam; Job van der Palen; Frans H C de Jongh; Michiel M M Eijsvogel Journal: Sleep Breath Date: 2018-03-21 Impact factor: 2.816