Will Obstructive Sleep Apnea and Apnea/Hypopnea Index Be Corrected Following Alveolar Cleft Reconstruction?

Abstract

BACKGROUND Obstructive sleep apnea is a disorder of repetitive complete or partial airway obstruction during sleep. The aim of this study was to assess the impact of alveolar cleft reconstruction on the obstructive sleep apnea (OSA) condition and apnea/hypopnea index (AHI). METHODS In a double-blinded prospective quasi-experimental study, all healthy systemic children (n=30 female cleft patients) with unilateral alveolar cleft defects within the age range of 8-14 years and BMI less than 30 kg/m 2 who admitted for alveolar cleft repair were enrolled. OSA monitoring was performed one week before surgery, and 3 months postoperatively by Apnea Link device. Sleep apnea indices such as AHI, respiratory disturbance index (RDI), oxygen desaturation index (ODI) and oxyhemoglobin saturation (SpO2) as well as pulse rate (PR) and respiratory rate (RR) were the variables. RESULTS The patients' mean age was 11.0±1.4 years, and BMI average was 21.48±4.4 kg/m 2. Mean AHI was 21.6±5.0 events/hour, preoperatively; which decreased significantly and reached 4.4±2.5 events/hour after alveolar cleft reconstruction surgery (p=0.005). Moreover, the other OSA variables (SpO2, RDI, and ODI), as well as vital signs (PR, and RR) improved postoperatively (p=0.005). In other words, the preoperative moderate OSA status relieved after alveolar cleft repair and reconstruction. CONCLUSION Our study showed that the OSA and AHI ameliorated after bone graft surgery in alveolar cleft repair. More clinical trials including

Efficacy and safety of Chinese medicine for obstructive sleep apnea

“…Main outcomes: The primary modes of measurement were the PSG monitoring indicators and the Epworth Sleep Scale (ESS). The monitoring indicators of PSG include AHI index, [ 11 ] the average and lowest blood oxygen. [ 12 ] The ESS is composed of 8 situational questions used to evaluate the severity of daytime sleepiness.…”

Bimaxillary Orthognathic Surgery Does Not Induce Obstructive Sleep Apnea in Skeletal Class III Patients

“…4,[14][15][16][17][18][19][20] Older age, male sex, obesity, familial history, postmenopausal state, craniofacial abnormalities, smoking, and alcohol consumption have all been recognized as possible risk factors for OSA. 1,4,12,[14][15][16][17][18][19][20][21][22][23][24] Since no solitary definite cause has been confirmed yet in the development of OSA, it seems that this disorder is of multifactorial etiology, most likely linked to anatomic abnormalities of the nasopharyngeal and oropharyngeal spaces and surgical interventions such as palatoplasty, pharyngeal flaps, and a considerable mandibular posterior displacement. 1,4,[14][15][16][17][18][19][20][21][22][23][24] A combination of mandibular setback surgery with simultaneous maxillary advancement is a widely performed and highly favored treatment modality for skeletal class III malocclusions.…”

“…1,4,12,[14][15][16][17][18][19][20][21][22][23][24] Since no solitary definite cause has been confirmed yet in the development of OSA, it seems that this disorder is of multifactorial etiology, most likely linked to anatomic abnormalities of the nasopharyngeal and oropharyngeal spaces and surgical interventions such as palatoplasty, pharyngeal flaps, and a considerable mandibular posterior displacement. 1,4,[14][15][16][17][18][19][20][21][22][23][24] A combination of mandibular setback surgery with simultaneous maxillary advancement is a widely performed and highly favored treatment modality for skeletal class III malocclusions. 4,22,25,26 Mandibular setback surgery can reduce the pharyngeal airway space by altering the position of the hyoid bone and tongue, increasing the chances for OSA.…”

“…1,2,4,14,15,23,34,35 This comprehensive procedure utilizes electroencephalogram, electrocardiogram, electromyogram, electrooculogram, pulse oximetry, recordings of airflow, snoring, and body position. 1,4,14,15,20,21,23,[34][35][36][37] Attended, in-laboratory PSG is expensive, time-consuming, and in some cases, burdensome to obtain. 14,15,23,34,35 Several recently conducted studies have used multiple questionnaires as screening tools for OSA.…”

“…Portable technologies have proven to be cost-effective in determining the severity and the risk of absence or presence of OSA. 1,21,35 Recent studies have used a home sleep test (HST) device as an alternative to PSG for the diagnosis of OSA. 21,35,[39][40][41][42][43][44][45] The authors hypothesized that, OSA might occur in class III patients following bimaxillary orthognathic surgery, especially because of the mandibular setback procedure.…”