Effectiveness of orthognathic surgery by maxillomandibular advancement combined with soft tissue surgery as curative treatment for obstructive sleep apnea syndrome.
Résumé
Objective/Background
The aim of this study was to compare the efficacy of orthognathic surgery combined with soft tissue surgery with that of soft tissue surgery alone as curative treatments for moderate to severe obstructive sleep apnea (OSA) syndrome.
Patients/Methods
This retrospective cohort study included 50 patients aged ≥18 years who underwent orthognathic surgery combined with soft tissue surgery or soft tissue surgery alone for OSA syndrome (apnea-hypopnea index [AHI]: >15). The primary outcome was the improvement in AHI measured by overnight in-laboratory polysomnography before and at 6 months after the surgical treatment by. The secondary outcome was the postoperative AHI.
Results
Twenty-eight (56 %) patients underwent orthognathic surgery combined with soft tissue surgery, while 22 (44 %) underwent soft tissue surgery only. There were no significant between-group differences in sex (p = 0.53), age (p = 0.08), body mass index (p = 0.42), and preoperative AHI (p = 0.17). The mean improvement in AHI at 6 months after surgery was significantly greater in the orthognathic surgery group than in the soft tissue surgery group (32.18 vs. 10.41; p < 0.0001). Similarly, the mean postoperative AHI was significantly lower in the orthognathic surgery group than in the soft tissue surgery group (8.46 vs. 29.62; p < 0.0001).
Conclusion
Compared with soft tissue surgery alone, orthognathic surgery combined with soft tissue surgery is more effective as curative treatment for OSA syndrome.