Orthognathic surgery is developing as a viable and long-lasting treatment option for obstructive sleep apnoea syndrome (OSAS). There have been a growing number of publications that report the benefit of using conventional orthognathic techniques for OSAS. In the present retrospective study the authors report their successes in the application of orthognathic procedures for OSAS in a fairly large series of 51 patients. They compared preoperative and postoperative apnoea / hypopnoea indices (AHI), scores for the Epworth sleepiness scale (ESS), and lowest oxygen saturation to measure surgical success (AHI of less than 15 and a 50% reduction in the number of apnoeas or hypopnoea/hour) and surgical cure (AHI of less than five). We identified 51 patients (mean age 44 years) with a mean body mass index of 29 (3.4). In total 42 patients had bimaxillary advancement with genioplasty. Differences in mean preoperative and postoperative values were significant for all three outcome measures (AHI: 42 (17) to 8 (7) p<0.001; ESS: 14 (4) to 5 (4) p<0.001; lowest oxygen saturation: 76% (11%) to 83% (7%); p=0.006). In the postoperative sleep study 85% of patients met the criteria for surgical success. The authors conclude that bimaxillary advancement results in a high rate of success in patients with OSA and that the surgery has a role in the management of selected patients who do not adhere to continuous positive airway pressure.
Orthognathic surgery for OSAS
Reviewed by Sampath Chandra Prasad
Orthognathic surgery in the management of obstructive sleep apnoea: experience from maxillofacial surgery unit in the United Kingdom.
