Assessment of Surgical Accuracy in Maxillomandibular Advancement Surgery for Obstructive Sleep Apnea: A Preliminary Analysis
This retrospective study aimed to: (1) investigate the surgical accuracy of maxillomandibular advancement (MMA) in obstructive sleep apnea (OSA) patients, with a specific focus on maxillary and mandibular advancement and counter-clockwise rotation and (2) investigate the correlation between the amou...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-10-01
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| Series: | Journal of Personalized Medicine |
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| Online Access: | https://www.mdpi.com/2075-4426/13/10/1517 |
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| author | Jean-Pierre T. F. Ho Ning Zhou Tom C. T. van Riet Ruud Schreurs Alfred G. Becking Jan de Lange |
| author_facet | Jean-Pierre T. F. Ho Ning Zhou Tom C. T. van Riet Ruud Schreurs Alfred G. Becking Jan de Lange |
| author_sort | Jean-Pierre T. F. Ho |
| collection | DOAJ |
| description | This retrospective study aimed to: (1) investigate the surgical accuracy of maxillomandibular advancement (MMA) in obstructive sleep apnea (OSA) patients, with a specific focus on maxillary and mandibular advancement and counter-clockwise rotation and (2) investigate the correlation between the amount of achieved advancement and the reduction in the relative apnea hypopnea index (AHI). Sixteen patients, for whom a three-dimensional virtual surgical plan was generated preoperatively and a computed tomography scan (CT) or cone-beam computer tomography (CBCT) was acquired postoperatively, were included. The postoperative CT or CBCT was compared to the virtual surgical plan, and differences in the mandibular and maxillary advancement and counter-clockwise rotation were assessed. Maxillary and mandibular advancement (median 3.1 mm, <i>p</i> = 0.002 and 2.3 mm, <i>p</i> = 0.03, respectively) and counter-clockwise rotation (median 3.7°, <i>p</i> = 0.006 and 4.7°, <i>p</i> = 0.001, respectively) were notably less than intended. A significant correlation was found between the planned maxillary advancement and the difference between the planned and actual maxillary advancement (<i>p</i> = 0.048; adjusted R<sup>2</sup> = 0.1979) and also between the planned counter-clockwise rotation and the difference between the planned and actual counter-clockwise rotation for the mandible (<i>p</i> = 0.012; adjusted R<sup>2</sup> = 0.3261). Neither the maxilla-first nor the mandible-first surgical sequence proved to be superior in terms of the ability to achieve the intended movements (<i>p</i> > 0.45). Despite a significant reduction (<i>p</i> = 0.001) in the apnea hypopnea index (AHI) from a median of 62.6 events/h to 19.4 events/h following MMA, no relationship was found between the extent of maxillary or mandibular advancement and AHI improvement in this small cohort (<i>p</i> = 0.389 and <i>p</i> = 0.387, respectively). This study underlines the necessity for surgeons and future research projects to be aware of surgical inaccuracies in MMA procedures for OSA patients. Additionally, further research is required to investigate if sufficient advancement is an important factor associated with MMA treatment outcome. |
| first_indexed | 2024-03-10T21:08:26Z |
| format | Article |
| id | doaj.art-f3be1206f5204c6aba3b4d4456f8ec47 |
| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-10T21:08:26Z |
| publishDate | 2023-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Personalized Medicine |
| spelling | doaj.art-f3be1206f5204c6aba3b4d4456f8ec472023-11-19T17:02:45ZengMDPI AGJournal of Personalized Medicine2075-44262023-10-011310151710.3390/jpm13101517Assessment of Surgical Accuracy in Maxillomandibular Advancement Surgery for Obstructive Sleep Apnea: A Preliminary AnalysisJean-Pierre T. F. Ho0Ning Zhou1Tom C. T. van Riet2Ruud Schreurs3Alfred G. Becking4Jan de Lange5Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The NetherlandsDepartment of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The NetherlandsDepartment of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The NetherlandsDepartment of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The NetherlandsDepartment of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The NetherlandsDepartment of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The NetherlandsThis retrospective study aimed to: (1) investigate the surgical accuracy of maxillomandibular advancement (MMA) in obstructive sleep apnea (OSA) patients, with a specific focus on maxillary and mandibular advancement and counter-clockwise rotation and (2) investigate the correlation between the amount of achieved advancement and the reduction in the relative apnea hypopnea index (AHI). Sixteen patients, for whom a three-dimensional virtual surgical plan was generated preoperatively and a computed tomography scan (CT) or cone-beam computer tomography (CBCT) was acquired postoperatively, were included. The postoperative CT or CBCT was compared to the virtual surgical plan, and differences in the mandibular and maxillary advancement and counter-clockwise rotation were assessed. Maxillary and mandibular advancement (median 3.1 mm, <i>p</i> = 0.002 and 2.3 mm, <i>p</i> = 0.03, respectively) and counter-clockwise rotation (median 3.7°, <i>p</i> = 0.006 and 4.7°, <i>p</i> = 0.001, respectively) were notably less than intended. A significant correlation was found between the planned maxillary advancement and the difference between the planned and actual maxillary advancement (<i>p</i> = 0.048; adjusted R<sup>2</sup> = 0.1979) and also between the planned counter-clockwise rotation and the difference between the planned and actual counter-clockwise rotation for the mandible (<i>p</i> = 0.012; adjusted R<sup>2</sup> = 0.3261). Neither the maxilla-first nor the mandible-first surgical sequence proved to be superior in terms of the ability to achieve the intended movements (<i>p</i> > 0.45). Despite a significant reduction (<i>p</i> = 0.001) in the apnea hypopnea index (AHI) from a median of 62.6 events/h to 19.4 events/h following MMA, no relationship was found between the extent of maxillary or mandibular advancement and AHI improvement in this small cohort (<i>p</i> = 0.389 and <i>p</i> = 0.387, respectively). This study underlines the necessity for surgeons and future research projects to be aware of surgical inaccuracies in MMA procedures for OSA patients. Additionally, further research is required to investigate if sufficient advancement is an important factor associated with MMA treatment outcome.https://www.mdpi.com/2075-4426/13/10/1517obstructive sleep apneasurgeryorthognathic surgical proceduresosteotomyaccuracy |
| spellingShingle | Jean-Pierre T. F. Ho Ning Zhou Tom C. T. van Riet Ruud Schreurs Alfred G. Becking Jan de Lange Assessment of Surgical Accuracy in Maxillomandibular Advancement Surgery for Obstructive Sleep Apnea: A Preliminary Analysis Journal of Personalized Medicine obstructive sleep apnea surgery orthognathic surgical procedures osteotomy accuracy |
| title | Assessment of Surgical Accuracy in Maxillomandibular Advancement Surgery for Obstructive Sleep Apnea: A Preliminary Analysis |
| title_full | Assessment of Surgical Accuracy in Maxillomandibular Advancement Surgery for Obstructive Sleep Apnea: A Preliminary Analysis |
| title_fullStr | Assessment of Surgical Accuracy in Maxillomandibular Advancement Surgery for Obstructive Sleep Apnea: A Preliminary Analysis |
| title_full_unstemmed | Assessment of Surgical Accuracy in Maxillomandibular Advancement Surgery for Obstructive Sleep Apnea: A Preliminary Analysis |
| title_short | Assessment of Surgical Accuracy in Maxillomandibular Advancement Surgery for Obstructive Sleep Apnea: A Preliminary Analysis |
| title_sort | assessment of surgical accuracy in maxillomandibular advancement surgery for obstructive sleep apnea a preliminary analysis |
| topic | obstructive sleep apnea surgery orthognathic surgical procedures osteotomy accuracy |
| url | https://www.mdpi.com/2075-4426/13/10/1517 |
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