A Comprehensive Strategy for Improving Nasal Outcomes after Large Maxillomandibular Advancement for Obstructive Sleep Apnea

被引：11
作者：
Abdelwahab, Mohamed [1 ,2 ,3 ]
Poomkonsarn, Sasikarn [1 ,4 ]
Ren, Xiatong [1 ,5 ]
Awad, Michael [1 ,6 ]
Capasso, Robson [1 ]
Riley, Robert [1 ]
Most, Sam [2 ]
Liu, Stanley Yung-Chuan [1 ]
机构：
[1] Stanford Univ, Dept Otolaryngol Head & Neck Surg, Div Sleep Surg, Sch Med, 801 Welch Rd, Stanford, CA 94304 USA
[2] Stanford Univ, Dept Otolaryngol Head & Neck Surg, Div Facial Plast & Reconstruct Surg, Sch Med, Stanford, CA 94304 USA
[3] Mansoura Univ, Dept Otolaryngol Head & Neck Surg, Fac Med, Mansoura, Egypt
[4] Rangsit Univ, Rajavithi Hosp, Coll Med, Ctr Excellence Otolaryngol Head & Neck Surg, Bangkok, Thailand
[5] Shantou Univ, Longgang Dist Cent Hosp Shenzhen, Dept Otolaryngol, Med Coll, Shenzhen, Peoples R China
[6] Northwestern Univ, Dept Otolaryngol Head & Neck Surg, Div Sleep Surg, Chicago, IL USA
来源：
FACIAL PLASTIC SURGERY & AESTHETIC MEDICINE | 2021年 / 23卷 / 06期
关键词：
MAXILLARY EXPANSION DOME; UPPER AIRWAY; PRESSURE; POSTURE; SURGERY; LENGTH;
D O I：
10.1089/fpsam.2020.0569
中图分类号：
R61 [外科手术学];
学科分类号：
摘要：
Background: Rate of corrective nasal surgery after maxillomandibular advancement (MMA) for obstructive sleep apnea (OSA) has been reported to be 18.7% for functional and aesthetic indications. Objective: Describe a comprehensive strategy to optimize nasal outcomes with MMA for OSA. Methods: A retrospective review of patients undergoing MMA for OSA in a tertiary referral center was performed, with a comprehensive perioperative intervention to optimize nasal outcomes from January 2014 to February 2018. Outcomes included the Apnea-Hypopnea Index (AHI), oxygen saturation (SpO(2)) nadir, corrective nasal surgery needed after MMA, and Nasal Obstruction Symptom Evaluation (NOSE) scores. Results: AHI after MMA showed significant reduction (-34.65, p < 0.001), SpO(2) nadir increased (+6.08, p < 0.001), and NOSE scores decreased (-5.96, p < 0.001). Corrective nasal surgery needed after MMA was reported in 6.5% (8 of 122) subjects at a mean of 8.5 months, ranging from 1 to 24.7 months. Six subjects underwent either septoplasty and/or valve stenosis repair, and two subjects underwent functional and aesthetic rhinoplasty. Conclusion: A perioperative strategy was applied since 2014 that showed effectiveness in reducing post-MMA corrective nasal surgery to 6.5%.
引用
收藏
页码：437 / 442
页数：6
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