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Maxillary Surgical Procedures for Correction of Obstructive Sleep Apnea

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Management of Obstructive Sleep Apnea

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Abstract

Persistent obstructive sleep apnea not addressed with conservative therapy often requires surgical intervention using skeletal advancement. Orthopedic procedures such as rapid maxillary expansion (RME) in children, surgically assisted rapid palatal expansion (SARPE), or segmental Lefort surgery demonstrates improvement in adults. For the most severe cases, counterclockwise rotation of the maxillomandibular complex has become the surgery of choice to reduce airway resistance and improve tongue posture.

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References

  1. Stierer T, Punjabi NM. Demographics and diagnosis of obstructive sleep apnea. Anesthes Clin North Am. 2005;23:405–20.

    Article  Google Scholar 

  2. Peppard NR, Young T, Palta M, Skatrud J. Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med. 2000;342(19):1378–84.

    Article  CAS  PubMed  Google Scholar 

  3. Pedrotti E, Demasi CL, Bruni E, et al. Prevalence and risk factors of eye diseases in adult patients with obstructive sleep apnea: results from the SLE.E.P.Y cohort study. BMJ Open. 2017;7:e016142. https://doi.org/10.1136/bmjopen-2017-016142.

  4. Elshaug AG, Moss JR, Southcott AM, Hiller JE. Redefining success in airway surgery for obstructive sleep apnea: a meta analysis and synthesis of the evidence. Sleep. 2007;30(4):461–7.

    Article  PubMed  Google Scholar 

  5. Somers VK, White DP, Amin R, et al. Sleep apnea and cardiovascular disease: An American Heart Association/American College of Cardiology Foundation Scientific Statement from American Heart Association Council for High Blood pressure Research Professional Education Committee, Council of Clinical Cardiology, Stroke Council and Council on Cardiovascular Nursing. J Am Coll Cardiol. 2008;52:686–717.

    Article  PubMed  Google Scholar 

  6. Epstein LJ, Kristo D, Strollo PJ, et al. Clinical guideline for evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med. 2009;5(3):263–76.

    Article  PubMed  Google Scholar 

  7. Holty J, Cuilleminault C. Maxillomandibular advancement for the treatment of obstructive sleep apnea; a systemic review and meta analysis. Sleep Med Rev. 2010;14:287–97.

    Article  PubMed  Google Scholar 

  8. Dentino K, Ganjawalla K, Inverso G, et al. Upper airway length is predictive of obstructive sleep apnea is syndromic craniosynostosis. J Oral Maxillofac Surg. 2015;73:S20–5.

    Article  PubMed  Google Scholar 

  9. Susarla SM, Abrahamson ZR, Dodson, et al. Cephalometric measurement of upper airway length correlates with presence of severity of obstructive sleep apnea. J Oral Maxillofac Surg. 2010;68:2846–55.

    Article  PubMed  Google Scholar 

  10. Abrahamson Z, Susarla SM, Lawler M, et al. Three-dimensional computed tomographic airway analysis of patients with obstructive sleep apnea treated by maxillomandibular advancement. J Oral Maxillofac Surg. 2011;69:677–86.

    Article  Google Scholar 

  11. Sursarla SM, Abramson ZR, Dodson TB, et al. Upper airway length decreases after maxillomandibular advancement in patients with obstructive sleep apnea. J Oral Maxillofac Surg. 2011;69:2872–8.

    Article  Google Scholar 

  12. Zinser MJ, Zachow S, Sailer HF, et al. Bimaxilary ‘rotational advancement’ procedures in patients with obstructive sleep apnea: a 3-dimensional airway analysis of morphological changes. Int J Oral Maxillofac Surg. 2013;42:569–78.

    Article  CAS  PubMed  Google Scholar 

  13. Butterfield KJ, Marks PL, McLean L, et al. Pharyngeal airway morphology in healthy individuals and in obstructive sleep apnea in patients treated with maxillomandibular advancement: a comparative study. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015;119(3):285–92.

    Article  PubMed  Google Scholar 

  14. Vinha PP, Faria AC, Xavier SP, et al. Enlargement of the pharynx resulting from surgically assisted rapid maxillary expansion. J Oral Maxillofac Surg. 2016;74:369–79.

    Article  PubMed  Google Scholar 

  15. Yu CC, Hsiao HD, Lee LC. Computational fluid dynamic study on obstructive sleep apnea syndrome treated with maxillomandibular advancement. J Craniofacial Surg. 2009;20(2):426–30.

    Article  Google Scholar 

  16. Liu SYC, Huon LK, Powell NB, et al. Lateral pharyngeal wall tension after maxillomandibular advancement for obstructive sleep apnea is a marker for surgical success: observations from drug induced sleep endoscopy. J Oral Maxillofac Surg. 2015;73:1575–82.

    Article  PubMed  Google Scholar 

  17. Goodday RH, Bourque SE, Edwards PB. Objective and subjective outcomes following maxillomandibular advancement surgery for treatment of patients with extremely severe obstructive sleep apnea. J Oral Maxillofac Surg. 2016;74:583–9.

    Article  PubMed  Google Scholar 

  18. Zaghi S, Holty JE, Certal V, et al. Maxillomandibular advancement for treatment of obstructive sleep apnea, a meta analysis. JAMA Otolaryngol Head Neck Surg. 2016;142(1):58–66.

    Article  PubMed  Google Scholar 

  19. Yu W, Wang M, He J, et al. Combined counterclockwise maxillomandibular advancement and uvulopalatopharyngoplasty surgeries for severe obstructive sleep apnea. J Craniofacial Surg. 2017;28(2):366–71.

    Google Scholar 

  20. Islam S, Uwadiae N, Ormiston IW. Othognathic surgery in the management of obstructive sleep apnea: experience from maxillofacial surgery unit in the United Kingdom. Br J Oral Maxillofac Surg. 2014;52:496–500.

    Article  PubMed  Google Scholar 

  21. Boyd SB, Walters AD, Waite P, et al. Long term effectiveness and safety of maxillomandibular advancement for treatment of obstructive sleep apnea. J Clin Sleep Med. 2015;11(7):699–708.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Won CH, Li KK, Guilleminault C. Surgical treatment of obstructive sleep apnea. Proc Am Thorac Soc. 2008;5:193–9.

    Article  PubMed  Google Scholar 

  23. Varghese R, Adams NG, Slocumb NL, et al. Maxillomandibular advancement in the management of obstructive sleep apnea. Int J Otolaryngol. 2012;2012:373025.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Butterfield KJ, Marks PL, McLean L, et al. Quality of life assessment after maxillomandibular advancement surgery for obstructive sleep apnea. J Oral Maxillofac Surg. 2016;74:1228–37.

    Article  PubMed  Google Scholar 

  25. Lee KW. Effect of orthognathic surgery on posterior airway space. Ann Acad Med. 2008;37(8):p677–82.

    Google Scholar 

  26. Fairburn SC, Waite PD, Vilos G, et al. Three-dimensional changes in upper airways of patients with obstructive sleep apnea following maxillomandibular advancement. J Oral Maxillofac Surg. 2007;65:6–12.

    Article  PubMed  Google Scholar 

  27. Faria AC, Xavier SP, Silva SN, et al. Cephalometric analysis of modifications of the pharynx due to maxilla-mandibular advancement surgery in patients with obstructive sleep apnea. Int J Oral Maxillofac Surg. 2013;42:579–84.

    Article  CAS  PubMed  Google Scholar 

  28. Schendel SA, Broujerdi JA, Jacobson RL. Three dimensional upper airway changes with maxillomandibular advancement for obstructive sleep apnea treatment. Am J Orthod Dentofac Orthop. 2009;135:468–79.

    Article  Google Scholar 

  29. Comacho M, Chang ET, Song SA, et al. Rapid maxillary expansion for pediatric obstructive sleep apnea: a systematic review and meta-analysis. Laryngoscope. 2017;127:1712–9.

    Article  CAS  Google Scholar 

  30. Villa MP, Rizzoli A, Miano S, et al. Efficacy of rapid maxillary expansion in children with obstructive sleep apnea syndrome: 36 months of follow-up. Sleep Breath. 2011;15:179–84.

    Article  PubMed  Google Scholar 

  31. McNamara JA, Lione R, Franchi L, et al. The role of rapid maxillary expansion in the promotion of oral and general health. Prog Orthod. 2015;16:33.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Galeotti A, Pavone M, De Vincentiis DE. Effects of simultaneous palatal expansion and mandibular advancement in child suffering from OSA. Acta Otorhinolaryngol Ital. 2016;36:328–32.

    CAS  PubMed  PubMed Central  Google Scholar 

  33. Villa MP, Malagola C, Pagani J, et al. Rapid maxillary expansion in children with obstructive sleep apnea syndrome: 12 month follow-up. Sleep Med. 2007;8:128–34.

    Article  PubMed  Google Scholar 

  34. Pirelli P, Saponara M, Guilleminault C. Rapid maxillary expansion (RME) for pediatric obstructive sleep apnea: a 12 year follow-up. Sleep Med. 2015;16:993–35.

    Article  Google Scholar 

  35. Iwasaki T, Saitoh I, Takemoto Y, et al. Tongue posture improvement and pharyngeal airway enlargement as secondary effects of rapid maxillary expansion: a cone beam computed tomography study. Am J Orthod Dentofac Orthop. 2013;143(2):235–45.

    Article  Google Scholar 

  36. Bach N, Tuomilehto H, Gauthier C, et al. The effect of surgically assisted rapid maxillary expansion on sleep architecture: an exploratory risk study in healthy young adults. J Oral Rehabil. 2014;40:818–25.

    Article  Google Scholar 

  37. Conley SR, Legan HL. Correction of severe obstructive sleep apnea with bimaxillary transverse distraction osteogenesis and maxillomandibular advancement. Am J Orthod Dentofac Orthop. 2006;129:283–92.

    Article  Google Scholar 

  38. Foltan R, Hoffmannova J, Pavlikova G, et al. The influence of orthognathic surgery on ventilation during sleep. Int J Oral Maxillofac Surg. 2011;40:146–9.

    Article  PubMed  Google Scholar 

  39. Liu SYC, Guilleminault C, Huon LK, et al. Distraction osteogenesis maxillary expansion (DOME) for adult obstructive sleep apnea patients with high arched palate. Otolaryngol Head Neck Surg. 2017;157(2):345–8.

    Article  PubMed  Google Scholar 

  40. Posnick JC, Agnihotri N. Consequences and management of nasal airway obstruction in the dentofacial deformity patient. Curr Opin Otolaryngol Head Neck Surg. 2010;18(4):323–31.

    Article  PubMed  Google Scholar 

  41. Abdullatif J, Certal V, Zaghi S. Maxillary expansion and maxillomandibular expansion for adult OSA: a systematic review and meta-analysis. J Craniomaxillofac Surg. 2016;44(5):574–8.

    Article  PubMed  Google Scholar 

  42. Wolford LM, Hilliard FW, Dugan DJ. Surgical treatment objective. A systematic approach to the prediction tracing. St Louis: Mosby Year Book; 1985. p. 54–74.

    Google Scholar 

  43. Bell WH. Revascularization and bone healing after anterior maxillary osteotomy: a study using adult rhesus monkeys. J Oral Surg. 1969;27:249–55.

    CAS  PubMed  Google Scholar 

  44. Obwegeser HL. Surgical correction of the small or retrodisplaced maxilla: the “dish-face” deformity. Plast Reconstr Surg. 1969;43:351.

    Article  CAS  PubMed  Google Scholar 

  45. Epker BN, Wolford LM. Transverse maxillary deficiency dentofacial deformities: integrated orthodontic and surgical correction. St. Louis: Mosby; 1980.

    Google Scholar 

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Author information

Authors and Affiliations

  1. Kentuckiana Oral and Maxillofacial Surgery, Louisville, KY, USA

    Will R. Allen

  2. North County Oral and Facial Surgery Center, Escondido, CA, USA

    Matt J. Madsen

Authors
  1. Will R. Allen
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  2. Matt J. Madsen
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Editor information

Editors and Affiliations

  1. Orthodontics, Saint Louis University Orthodontics, Saint Louis, MO, USA

    Ki Beom Kim

  2. Orthodontics, Saint Louis University Orthodontics, Saint Louis, MO, USA

    Reza Movahed

  3. Washington University in St. Louis School of Medicine, Saint Louis, MO, USA

    Raman K. Malhotra

  4. Otolaryngology-Head and Neck Surgery, University of Michigan–Ann Arbor, Ann Arbor, MI, USA

    Jeffrey J. Stanley

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Allen, W.R., Madsen, M.J. (2021). Maxillary Surgical Procedures for Correction of Obstructive Sleep Apnea. In: Kim, K.B., Movahed, R., Malhotra, R.K., Stanley, J.J. (eds) Management of Obstructive Sleep Apnea. Springer, Cham. https://doi.org/10.1007/978-3-030-54146-0_25

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  • DOI: https://doi.org/10.1007/978-3-030-54146-0_25

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-54145-3

  • Online ISBN: 978-3-030-54146-0

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