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2012 Jan-Mar; Vol 3, No 1:e5 |
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Bimaxillary Advancement as the Initial Treatment of Obstructive Sleep Apnea: Five Years Follow-Up of the Pori Experience J Oral Maxillofac Res 2012 (Jan-Mar);3(1):e5 doi:10.5037/jomr.2012.3105 |
Bimaxillary Advancement as the Initial Treatment of Obstructive Sleep Apnea: Five Years Follow-Up of the Pori Experience
1Department of Oral and Maxillofacial Surgery, Institute of Dentistry, University of Oulu, Oulu, Finland.
Corresponding author:
Institute of Dentistry, University of Oulu
Box 5281, FIN-90014, Oulu
Finland
Phone: +358-537-5439
Fax: +358-537-5560
E-mail: antti.raunio@oulu.fi
ABSTRACT
Objectives: Bimaxillary advancement surgery has proven to be effective treatment of obstructive sleep apnea syndrome. According to the Stanford protocol upper airway soft tissue surgery or advancement of tongue by chin plastic surgery is first carried out and if obstructive sleep apnea persists, then bimaxillary advancement is done. This study describes the 5 year outcome of 13 obstructive sleep apnea patients in whom the Stanford protocol was omitted and bimaxillary advancement was carried out as initial surgical treatment.
Material and Methods: Patients were divided in two groups. Group A comprised patients with obstructive sleep apnea (OSAS) confirmed by polysomnography in whom ODI-4 (oxygen desaturation index) was 5 or more. Group B consisted of patients with occlusal problems needing orthognathic surgery and with OSAS symptoms but no clear disease on polysomnography, where the ODI-4 index was less than 5. Both groups were treated with bimaxillary advancement surgery (BAS) as initial therapy.
Results: In the group A mean ODI-4 was 17.8 (SD 12) before treatment and 3.5 (SD 3.4) at 5-year follow-up (P = 0.018 in paired differences t-test). In group B the ODI-4 remained below 5. In group A mean saturation improved from 94.3% (SD 1.6) to 96.3% (SD 2), P = 0.115 and in group B from 96.3% (SD 1.2) to 97.8% (SD 1.7), P = 0.056 (in paired differences t-test). The static charge sensitive bed evaluation showed improvement in all patients except one.
Conclusions: Bimaxillary advancement surgery is safe and reliable as an initial surgical treatment of obstructive sleep apnea syndrome.
J Oral Maxillofac Res 2012 (Jan-Mar);3(1):e5
doi:10.5037/jomr.2012.3105
Accepted for publication: 29 March 2012
Keywords: obstructive sleep apnea; sleep-disordered breathing; maxillofacial orthognathic surgery; mandible; LeFort osteotomy; sagittal split ramus osteotomy.
To cite this article: Bimaxillary Advancement as the Initial Treatment of Obstructive Sleep Apnea: Five Years Follow-Up of the Pori Experience. J Oral Maxillofac Res 2012;3(1):e5 URL: http://www.ejomr.org/JOMR/archives/2012/1/e5/v3n1e5ht.htm |
Received: 25 February 2012 | Accepted: 29 March 2012 | Published: 1 April 2012
Copyright: © The Author(s). Published by JOMR under CC BY-NC-ND 3.0 licence, 2012.