Monitoring of Home Respiratory Polygraphy During Mandibular Distraction Osteogenesis Succeeded by LeFort I Osteotomy in Adult Patients With Obstructive Sleep Apnea

被引:0
|
作者
Martin, Galder Hernando [1 ]
Bueno, Pilar Rubio [2 ]
Moreno, Ana Capote [2 ]
Arjona, Beatriz Albarracin [3 ]
Cantolla, Joaquin Duran [4 ]
Wyx, Rybel [5 ]
机构
[1] Univ Basque Country, Dept Med, Barrio Sarriena S-N, Leioa 48940, Spain
[2] Hosp Univ Princesa, Oral & Maxillofacial Dept, Madrid, Spain
[3] Hosp Infanta Luisa, Oral & Maxillofacial Dept, Seville, Spain
[4] Araba Univ Hosp, Res Inst, OSI Araba, Vitoria, Spain
[5] Hosp Princesa, Neurophysiol Dept, Madrid, Spain
关键词
AIR-FLOW CHANNEL; MAXILLOMANDIBULAR ADVANCEMENT; DIAGNOSIS; POLYSOMNOGRAPHY; SURGERY; MANAGEMENT; STABILITY; SKELETAL; DEVICE;
D O I
10.1016/j.joms.2024.04.002
中图分类号
R78 [口腔科学];
学科分类号
1003 ;
摘要
Background: Bilateral internal ramus distraction (BIRD) is now part of select protocols for treating obstructive sleep apnea (OSA). Introducing a home monitoring protocol offers a valuable alternative to overnight laboratory polysomnography (PSG). Purpose: The purpose of this study was to evaluate and compare OSA parameters obtained via home respiratory polygraphy (HRP) and hospital PSG in a cohort of patients undergoing mandibular distraction for OSA management. Study Design, Setting, Sample: Hospital Universitario La Princesa (Madrid) researchers conducted a prospective cohort study with patients diagnosed with moderate (apnea-hypopnea index (AHI) = 15 to 30) to severe (AHI>30) OSA undergoing BIRD followed by LeFort maxillary osteotomy. Exclusion criteria were as follows: severe systemic diseases, central apneas, smoking, poor dental hygiene, or prior OSA interventions. Predictor Variable: The predictor variable was PSG and HRP techniques. Main Outcome Variables: The main outcome variable comprises a collection of OSA parameters, including the AHI, oxygen desaturation index (ODI), and time spent below 90% oxygen saturation (T90). These data were measured both before and after distraction, as well as after 6 mm, 9 mm, and 12 mm of mandibular distraction. Covariates: The covariates were age, sex, cardiovascular risk parameters, and the Epworth sleepiness scale. Analyses: Pearson's correlation analyzed AHI, ODI, and T90 values from PSG and HRP. Wilcoxon Signed Rank -Sum Test compared 2 distraction stages, and the Friedman Test evaluated 3 stages (P < .05). Multiple regression analysis assessed if covariates were independent risk factors for postoperative persistent OSA. Results: The study included 32 patients (25% with moderate and 75% with severe OSA). Final AHI was 10.9 +/- 8.9 (events/hour) with HRP, compared to 15.2 +/- 13.4 with PSG (r = 0.7, P < .05). ODI was 9.0 +/- 8.1 (des/h) with HRP and 8.7 +/- 9.5 with PSG (r = 0.85, P < .05). T90 was 1.6 +/- 2.2 with HRP and 1.3 +/- 3.0 with PSG (r = 0.6, P < .05). Based on HRP data, AHI improved from D1 (34.0 +/- 19.5) to D2 (20.8 +/- 14.1) and D3 (12.5 +/- 10.4) ( P < .05). ODI decreased from D1 (26.1 +/- 19.0) to D2 (16.0 +/- 12.6) and D3 (9.4 +/- 8.8) ( P < .05). T90 reduced from D1 (8.2 +/- 12.6) to D2 (4.1 +/- 5.2) and D3 (1.9 +/- 2.8) ( P < .05). Multiple regression analysis of comorbidities produced nonsignificant results. Conclusion and Relevance: Monitoring BIRD through HRP has demonstrated efficacy in yielding results that align with PSG. (c) 2024 American Association of Oral and Maxillofacial Surgeons
引用
收藏
页码:761 / 770
页数:10
相关论文
共 50 条
  • [21] Reliability of home respiratory polygraphy monitoring for diagnosis of sleep apnea/hypopnea syndrome (SAHS) in children
    Alonso-Alvarez, Maria-Luz
    Teran-Santos, Joaquin
    Cordero-Guevara, Jose-Aurelio
    Ordax-Carbajo, Estrella
    Navazo-Egueia, Ana-Isabel
    EUROPEAN RESPIRATORY JOURNAL, 2013, 42
  • [22] Analysis of micrognathia with obstructive sleep apnea syndrome improved by a combination of Le Fort I with horseshoe osteotomies, mandibular distraction osteogenesis, and genioplasty
    Koshinuma, Shinya
    Fujii, Takafumi
    Okamura, Takeshi
    Asada, Yasuyuki
    Machida, Yoshisato
    Yamamoto, Gaku
    CLINICAL CASE REPORTS, 2022, 10 (12):
  • [23] Management of obstructive sleep apnea syndrome secondary to temporomandibular joint ankylosis by mandibular elongation using distraction osteogenesis
    Guruprasad, Yadavalli
    Hemavathy, O. R.
    CONTEMPORARY CLINICAL DENTISTRY, 2012, 3 (01) : 69 - 73
  • [24] Comparison of treatment outcome and stability between distraction osteogenesis and LeFort I osteotomy in cleft patients with maxillary hypoplasia
    Baek, Seung-Hak
    Lee, Jin-Kyung
    Lee, Jong-Ho
    Kim, Myung-Jin
    Kim, Jong-Ryoul
    JOURNAL OF CRANIOFACIAL SURGERY, 2007, 18 (05) : 1209 - 1215
  • [25] VALIDATION OF HOME MONITORING WITH CNS SLEEP I/T IN PATIENTS WITH SUSPECTED OBSTRUCTIVE SLEEP-APNEA
    FERGUSON, KA
    KEENAN, SP
    ANDERSON, B
    FLEETHAM, JA
    AMERICAN REVIEW OF RESPIRATORY DISEASE, 1993, 147 (04): : A808 - A808
  • [26] Treatment of obstructive sleep apnea syndrome by mandibular elongation using osseous distraction followed by a Le Fort I advancement osteotomy: Case report
    Paoli, JR
    Lauwers, F
    Lacassagne, L
    Tiberge, M
    JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, 2001, 59 (02) : 216 - 219
  • [27] Home Respiratory Polygraphy and Spirometry in Normal Weight and Children with Obesity Suspected for Obstructive Sleep Apnea Syndrome: Are There Any Associations?
    Corbelli, Regula
    Barazzone, Constance
    Grasset Salomon, Carole
    Beghetti, Maurice
    Maggio, Albane B. R.
    PULMONARY MEDICINE, 2023, 2023
  • [28] Micrognathia with temporomandibular joint ankylosis and obstructive sleep apnea treated with mandibular distraction osteogenesis using skeletal anchorage: a case report
    Tomonari, Hiroshi
    Takada, Hiroko
    Hamada, Tomofumi
    Kwon, Sangho
    Sugiura, Tsuyoshi
    Miyawaki, Shouichi
    HEAD & FACE MEDICINE, 2017, 13
  • [29] Micrognathia with temporomandibular joint ankylosis and obstructive sleep apnea treated with mandibular distraction osteogenesis using skeletal anchorage: a case report
    Hiroshi Tomonari
    Hiroko Takada
    Tomofumi Hamada
    Sangho Kwon
    Tsuyoshi Sugiura
    Shouichi Miyawaki
    Head & Face Medicine, 13
  • [30] THE USE OF BISPECTRAL INDEX (BIS) MONITORING DURING SLEEP ENDOSCOPY (DISE) IN ADULT PATIENTS WITH OBSTRUCTIVE SLEEP APNEA
    Spiller, P.
    Ordoyne, L.
    Calligas, J.
    Asarkar, A.
    Dewan, K.
    SLEEP MEDICINE, 2024, 115 : 419 - 419