Ning Zhou1,2,3, Jean-Pierre T F Ho4,5,6, Wouter P Visscher4,5, Naichuan Su7, Frank Lobbezoo8, Jan de Lange4,5. 1. Amsterdam UMC Location University of Amsterdam, Department of Oral and Maxillofacial Surgery, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands. n.zhou@amsterdamumc.nl. 2. Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. n.zhou@amsterdamumc.nl. 3. Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. n.zhou@amsterdamumc.nl. 4. Amsterdam UMC Location University of Amsterdam, Department of Oral and Maxillofacial Surgery, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands. 5. Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. 6. Department of Oral and Maxillofacial Surgery, Northwest Clinics, Alkmaar, The Netherlands. 7. Department of Oral Public Health, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. 8. Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Abstract
PURPOSE: To identify potential predictors of surgical response to maxillomandibular advancement (MMA) in patients with obstructive sleep apnea (OSA) from the most common clinically available data (patient-related, polysomnographic, cephalometric, and surgical variables). METHODS: This was a retrospective study comprised of consecutive patients who underwent MMA for moderate to severe OSA. Relevant clinical, polysomnographic, cephalometric, and surgical variables were collected as independent variables (predictors). The association of the independent variables with a favorable surgical response to MMA was assessed in univariate and multivariate analyses. RESULTS: In 100 patients (82% male; mean age 50.5 years), the mean apnea hypopnea index [AHI] was 53.1 events/h. The rate of favorable surgical response was 67%. Based on multivariate analysis, patients with cardiovascular disease (CVD) had 0.140 times lower odds of a favorable response to MMA (OR: 0.140 [0.038, 0.513], P = 0.003). For each 1-unit increase in central apnea index (CAI) and superior posterior airway space (SPAS), there were 0.828 and 0.724 times lower odds to respond favorably to MMA (OR: 0.828 [0.687, 0.997], P = 0.047; and 0.724 [0.576, 0.910], P = 0.006), respectively. CONCLUSION: The findings of this study suggest that the surgical outcome of MMA may be less favorable when patients with OSA have certain phenotypic characteristics: the presence of CVD, higher CAI and larger SPAS. If confirmed in future studies, these variables may guide patient selection for MMA.
PURPOSE: To identify potential predictors of surgical response to maxillomandibular advancement (MMA) in patients with obstructive sleep apnea (OSA) from the most common clinically available data (patient-related, polysomnographic, cephalometric, and surgical variables). METHODS: This was a retrospective study comprised of consecutive patients who underwent MMA for moderate to severe OSA. Relevant clinical, polysomnographic, cephalometric, and surgical variables were collected as independent variables (predictors). The association of the independent variables with a favorable surgical response to MMA was assessed in univariate and multivariate analyses. RESULTS: In 100 patients (82% male; mean age 50.5 years), the mean apnea hypopnea index [AHI] was 53.1 events/h. The rate of favorable surgical response was 67%. Based on multivariate analysis, patients with cardiovascular disease (CVD) had 0.140 times lower odds of a favorable response to MMA (OR: 0.140 [0.038, 0.513], P = 0.003). For each 1-unit increase in central apnea index (CAI) and superior posterior airway space (SPAS), there were 0.828 and 0.724 times lower odds to respond favorably to MMA (OR: 0.828 [0.687, 0.997], P = 0.047; and 0.724 [0.576, 0.910], P = 0.006), respectively. CONCLUSION: The findings of this study suggest that the surgical outcome of MMA may be less favorable when patients with OSA have certain phenotypic characteristics: the presence of CVD, higher CAI and larger SPAS. If confirmed in future studies, these variables may guide patient selection for MMA.
Authors: Ning Zhou; Jean-Pierre T F Ho; Zhengfei Huang; René Spijker; Nico de Vries; Ghizlane Aarab; Frank Lobbezoo; Madeline J L Ravesloot; Jan de Lange Journal: Sleep Med Rev Date: 2021-03-17 Impact factor: 11.609
Authors: Balazs Horvath; Benjamin Kloesel; Michael M Todd; Daniel J Cole; Richard C Prielipp Journal: Anesthesiology Date: 2021-11-01 Impact factor: 7.892
Authors: Ning Zhou; Jean-Pierre T F Ho; Nico de Vries; Pien F N Bosschieter; Madeline J L Ravesloot; Jan de Lange Journal: J Clin Sleep Med Date: 2022-04-01 Impact factor: 4.062