The effect of maxillary-mandibular advancement surgery on two-dimensional cephalometric analysis, polysomnographic and patient-reported outcomes in 32 patients with sleep disordered breathing: A retrospective cohort study

Cruyssen, Fréderic Van der; Vuylsteke, Philippe; Claerhout, Michiel; Timmermans, Laurens; Delsupehe, Kathelijne G.

doi:10.1016/j.omsc.2019.100112

Cited by 3 publications

(3 citation statements)

References 19 publications

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“… 2011 ; Van der Cruyssen et al. 2019 ). Although clinical reports on the improvement of critical pressure are somewhat sparse, the observed improvement in our model is in good agreement with the widely reported high success rate (Zaghi et al.…”

Section: Discussionmentioning

confidence: 99%

Potential of computational models in personalized treatment of obstructive sleep apnea: a patient-specific partial 3D finite element study

Ayyalasomayajula,

Moxness,

Skallerud

2023

Biomech Model Mechanobiol

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The upper airway experiences mechanical loads during breathing. Obstructive sleep apnea is a very common sleep disorder, in which the normal function of the airway is compromised, enabling its collapse. Its treatment remains unsatisfactory with variable efficacy in the case of many surgeries. Finite element models of the upper airway to simulate the effects of various anatomic and physiologic manipulations on its mechanics could be helpful in predicting surgical success. Partial 3D finite element models based on patient-specific CT-scans were undertaken in a pilot study of 5 OSA patients. Upper airway soft tissues including the soft palate, hard palate, tongue, and pharyngeal wall were segmented around the midsagittal plane up to a width of 2.5 cm in the lateral direction. Simulations of surgical interventions such as Uvulopalatopharyngoplasty (UPPP), maxillo-mandibular advancement (MMA), palatal implants, and tongue implants have been performed. Our results showed that maxillo-mandibular advancement (MMA) surgery of 1 cm improved the critical closing pressure by at least 212.2%. Following MMA, the best improvement was seen via uvulopalatopharyngoplasty (UPPP), with an improvement of at least 19.12%. Palatal and tongue implants also offered a certain degree of improvement. Further, we observed possible interacting mechanisms that suggested simultaneous implementation of UPPP and tongue stiffening; and palatal and tongue stiffening could be beneficial. Our results suggest that computational modeling is a useful tool for analyzing the influence of anatomic and physiological manipulations on upper airway mechanics. The goal of personalized treatment in the case of OSA could be achieved with the use of computational modeling.

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Section: Discussionmentioning

confidence: 99%

Potential of computational models in personalized treatment of obstructive sleep apnea: a patient-specific partial 3D finite element study

Ayyalasomayajula,

Moxness,

Skallerud

2023

Biomech Model Mechanobiol

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“…However, the results illustrate an effect size that is big enough to show significance. The heart rate reduction of 5.9 beats/min was inferior to Lin's 8.7 beats/min 6 months after maxillary-mandibular advancement [45] but better than Sumi's 4.5 beats/min after 3-to 4-day use of nasal CPAP [11], Mayer's 3.4 beats/minute after 6 months of nasal CPAP therapy [37], de Paula Soares's 2.4 beats/min 6 to 9 months after lateral pharyngoplasty [46], and those reporting no change in mean heart rate after their treatments (e.g., see [47][48][49], including Van der Cruyssen's patients after maxillary-mandibular advancement [49]). Because the lack of detailed information in the literature made statistical analysis impossible, this was just the order of the mean heart rate reductions (so as to enable the AHI comparisons below).…”

Section: Discussionmentioning

confidence: 99%

A Non-Framework Multilevel Surgery May Reduce Mean Heart Rate in Patients with Very Severe Obstructive Apnea Having Confined Retroglossal Space and Framework

Huang

Lin

et al. 2020

Applied Sciences

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An elevated mean heart rate in untreated patients of obstructive sleep apnea (OSA) may lead to a higher risk of mortality and the development of various cardiovascular diseases. The elevation may positively relate to the severity of OSA and present in both wakefulness and sleep. A reduction in heart rate has been presented in reports of treating OSA patients with continuous positive airway pressure (CPAP). However, patients with very severe OSA may refuse use of CPAP devices and advocated surgeries, such as direct skeletal surgery or tracheostomy. It is unclear whether the non-framework multilevel surgery we reported previously can overcome the unfavorable anatomy and reduce mean heart rate, which serves as a risk factor of mortality. Here, we show that multilevel surgery reduced the mean heart rate from 68.6 to 62.7 with a mean reduction of 5.9 beats/min. The results suggest that the surgery may reduce the risk of consequences and mortality associated with an elevated mean heart rate, such as various cardiovascular diseases. We disclose these findings, along with the variations and possible risks to our future patients with very severe OSA who refuse or cannot use a CPAP device or reject direct skeletal surgery.

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“…However, examining threedimensional (3D) complex structures with twodimensional (2D) systems has limitations. These studies' findings have limited to linear measurements of sagittal or transverse aspects and cannot accurately represent the morphology of the airway space or the compromised areas leading to breathing disorders (6,7). Conventional computed tomography (CT) systems often overcome these limitations.…”

Section: Introductionmentioning

confidence: 99%

Investigation of the effects of bimaxillary surgery on the pharyngeal airway space

Koç¹,

Akkurt

2022

Int Dent Res

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Aim: To examine the pharyngeal airway space (PAS) changes in patients with skeletal Class III anomalies treated with two different bimaxillary surgery (BMS) techniques. Methodology: A total of 27 patients (15 females, 12 males) treated with BMS were divided into two groups: Group 1 (n=16, mean age: 20.67±2.82 years) consisted of patients who underwent maxillary-mandibular advancement (MMA), and Group 2 (n=11, mean age: 23.87±7.72 years) consisted of patients who underwent maxillary advancement and mandibular setback (MAMS). Cone-beam computed tomography (CBCT) records were taken immediately before (T1) and at least 5 months after (T2) BMS. To evaluate the postoperative PAS changes, the parameters of total volume (TV), upper volume (UV), lower volume (LV), and minimal axial area (Min-Ax) were evaluated using NemoCeph 10.4.2 software. Results: In Group 1, postoperative increases in the TV, NV, OV, and Min-Ax were determined as 4.5%, 6.6%, 3.07%, and 5.1%, respectively, but these increases were not statistically significant (p > 0.05). In Group 2, the following increases were determined: 10.4% in TV, 18.4% in NV, and 5.5% in OV. A postoperative decrease of 6.2% was determined for Min-Ax. These increases and decreases were not statistically significant (p > 0.05). There was no statistically significant difference between groups 1 and 2 in any pre- and postoperative parameters (p > 0.05). Conclusion: Neither of the BMS techniques caused any significant change in the PAS parameters. How to cite this article: Koç E, Akkurt A. Investigation of the effects of bimaxillary surgery on the pharyngeal airway space. Int Dent Res 2022;12(3):130-6. https://doi.org/10.5577/intdentres.2022.vol12.no3.4 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

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The effect of maxillary-mandibular advancement surgery on two-dimensional cephalometric analysis, polysomnographic and patient-reported outcomes in 32 patients with sleep disordered breathing: A retrospective cohort study

Cited by 3 publications

References 19 publications

Potential of computational models in personalized treatment of obstructive sleep apnea: a patient-specific partial 3D finite element study

Potential of computational models in personalized treatment of obstructive sleep apnea: a patient-specific partial 3D finite element study

A Non-Framework Multilevel Surgery May Reduce Mean Heart Rate in Patients with Very Severe Obstructive Apnea Having Confined Retroglossal Space and Framework

Investigation of the effects of bimaxillary surgery on the pharyngeal airway space

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