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Factors related to oxygen desaturation index during sleep 7 days after bilateral sagittal splitting ramus osteotomy in patients without previous obstructive sleep apnea

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Abstract

Purpose

The incidence of obstructive sleep apnea (OSA) immediately after surgery in patients with dentofacial deformities without previous OSA remains unknown. We aimed to perioperatively evaluate factors associated with oxygen desaturation index (ODI) during sleep, 7 days after bilateral splitting ramus osteotomy (BSSRO) in patients without previous OSA.

Methods

Fifty-one patients (15 males, 36 females) with dentofacial deformities, scheduled to undergo BSSRO, were included. Polysomnography was performed before orthognathic surgery. Perioperative OSA was evaluated with peripheral arterial tonometry on the day of surgery and 1, 2, 3, 4, and 7 days postoperatively. Rapid eye movement (REM) sleep periods and the ODI were measured. Factors associated with perioperative ODI after surgery were statistically analyzed.

Results

REM sleep periods were significantly decreased on the day of surgery and significantly increased at 4 and 7 days postoperatively, compared to the preoperative period. ODI increased on the day of surgery, decreased after 1 day, and increased again at 4 and 7 days postoperatively. ODI on the day of surgery was significantly increased due to increased preoperative ODI, overjet, and SN-MP angle and decreased SNA and SNB angle. ODI at 7 days postoperatively was significantly increased due to increased REM sleep periods and decreased SN-MP and gonial angle. ODI was increased in response to REM sleep periods 7 days after BSSO.

Conclusion

Airway management in patients with dentofacial deformity should be given more attention by preoperative assessment for OSA, even in the absence of previous OSA, until 7 days postoperatively due to REM rebound.

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8641, Japan

    Kentaro Ide, Kazuhiro Ooi, Rei Jokaji, Yutaka Kobayashi & Shuichi Kawashiri

  2. Department of Clinical Laboratory, Graduate School of Medicine, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, Japan

    Sayuri Takamichi & Masako Nakata

  3. Department of Respiratory Medicine, Graduate School of Medicine, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, Japan

    Kazuo Kasahara

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  1. Kentaro Ide
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  2. Kazuhiro Ooi
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Correspondence to Kazuhiro Ooi.

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The study protocol was approved by the institutional review board of Kanazawa University Hospital Research Ethical Committee (Ref. No.1765–3). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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All patients provided informed consent for the research purpose and for using their clinical data for this study.

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Ide, K., Ooi, K., Takamichi, S. et al. Factors related to oxygen desaturation index during sleep 7 days after bilateral sagittal splitting ramus osteotomy in patients without previous obstructive sleep apnea. Oral Maxillofac Surg 26, 123–130 (2022). https://doi.org/10.1007/s10006-021-00972-w

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