Surgical treatment options for obstructive sleep apnea in maxillofacial surgery: A review of literature review
Subject Areas : Oral and Maxillofacial SurgeryMehrdad Shahraki 1 , Sadra Amirpour Haradasht 2 , Niloofar EbrahimZade 3
1 - Assistant Professor of Oral and Maxillofacial Surgery Department of Oral And Maxillofacial Surgery, School of Dentistry Zahedan University of Medical Sciences, Zahedan, Iran
2 - Postgraduate Student, Department of Oral and Maxillofacial Surgery, School of Dentistry, Zahedan University of Medical Sciences, Zahedan, Iran
3 - Faculty of Dentistry, Student Research Committee, School of Dentistry, Zahedan University of Medical Science, Zahedan, Iran
Keywords: obstructive sleep apnea, OSA, surgical treatment, maxillofacial surgery, head and neck surgery,
Abstract :
Abstract Background and Aims: The purpose of this study was to investigate surgical treatment options for obstructive sleep apnea (OSA) in maxillofacial surgery. Materials and Methods: The review study focused on the keywords: obstructive sleep apnea, maxillofacial surgery, and surgical treatment. Articles were chosen based on relevant findings. English language articles were obtained via Google Scholar, Science Direct, PubMed, and Research Gate between November and December 2023. A total of 14 articles met the inclusion criteria and were reviewed. Results: The selected surgical treatment options within maxillofacial surgery for OSA include maxillomandibular advancement (MMA), genioglossus advancement, hyoid suspension, nasal surgery, and palatal surgery. These techniques aim to address anatomical factors contributing to airway collapse during sleep, ultimately improving airflow dynamics and reducing the severity of OSA. Conclusion: Maxillofacial surgical options provide promising alternatives for obstructive sleep apnea patients unable to tolerate CPAP therapy. Techniques are available but require experienced surgeons with a deep understanding of maxillofacial anatomy and sleep medicine. Collaborative efforts between maxillofacial surgeons and sleep medicine specialists are essential for optimal patient outcomes in managing obstructive sleep apnea surgically.
References:
1. Martinovic D, Tokic D, Puizina-Mladinic E, Kadic S, Lesin A, Lupi-Ferandin S, et al. Oromaxillofacial Surgery: Both a Treatment and a Possible Cause of Obstructive Sleep Apnea—A Narrative Review. Life. 2023;13(1):142.
2. Abbasi A, Gupta SS, Sabharwal N, Meghrajani V, Sharma S, Kamholz S, et al. A comprehensive review of obstructive sleep apnea. Sleep science (Sao Paulo, Brazil). 2021;14(2):142-54.
3. Trindade PAK, Nogueira VdSN, Weber SAT. Is maxillomandibular advancement an effective treatment for obstructive sleep apnea? Systematic literature review and meta-analysis. Brazilian journal of otorhinolaryngology. 2023;89:503-10.
4. Zhou N, Ho JTF, Spijker R, Aarab G, de Vries N, Ravesloot MJL, et al. Maxillomandibular Advancement and Upper Airway Stimulation for Treatment of Obstructive Sleep Apnea: A Systematic Review. Journal of clinical medicine. 2022;11(22).
5. Camacho M, Noller MW, Del Do M, Wei JM, Gouveia CJ, Zaghi S, et al. Long-term Results for Maxillomandibular Advancement to Treat Obstructive Sleep Apnea: A Meta-analysis. Otolaryngology–Head and Neck Surgery. 2019;160(4):580-93.
6. Mediano O, Romero-Peralta S, Resano P, Cano-Pumarega I, Sánchez-de-la-Torre M, Castillo-García M, et al. Obstructive Sleep Apnea: Emerging Treatments Targeting the Genioglossus Muscle. Journal of clinical medicine. 2019;8(10).
7. Cori JM, O'Donoghue FJ, Jordan AS. Sleeping tongue: current perspectives of genioglossus control in healthy individuals and patients with obstructive sleep apnea. Nature and science of sleep. 2018;10:169-79.
8. Maghsoudipour M, Nokes B, Bosompra N-O, Jen R, Li Y, Moore S, et al. A Pilot Randomized Controlled Trial of Effect of Genioglossus Muscle Strengthening on Obstructive Sleep Apnea Outcomes. Journal of clinical medicine. 2021;10(19):4554.
9. Samaha CJ, Tannous HJ, Salman D, Ghafari JG, Amatoury J. Role of surgical hyoid bone repositioning in modifying upper airway collapsibility. Frontiers in physiology. 2022;13:1089606.
10. Song SA, Wei JM, Buttram J, Tolisano AM, Chang ET, Liu SY-C, et al. Hyoid surgery alone for obstructive sleep apnea: A systematic review and meta-analysis. The Laryngoscope. 2016;126(7):1702-8.
11. Schoustra E, van Maanen P, den Haan C, Ravesloot MJL, de Vries N. The Role of Isolated Nasal Surgery in Obstructive Sleep Apnea Therapy-A Systematic Review. Brain sciences. 2022;12(11).
12. Park DY, Cho JH, Jung YG, Choi JH, Kim DK, Kim SW, et al. Clinical Practice Guideline: Clinical Efficacy of Nasal Surgery in the Treatment of Obstructive Sleep Apnea. Clinical and experimental otorhinolaryngology. 2023;16(3):201-16.
13. Ishii L, Roxbury C, Godoy A, Ishman S, Ishii M. Does Nasal Surgery Improve OSA in Patients with Nasal Obstruction and OSA? A Meta-analysis. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery. 2015;153(3):326-33.
14. Li HY. Palatal Surgery for Obstructive Sleep Apnea: From Ablation to Reconstruction. Sleep Med Clin. 2019;14(1):51-8.
15. Li H-Y, Tsai M-S, Lee L-A, Hsin L-J, Lee Y-C, Lin W-N, et al. Palatal hybrid surgery for obstructive sleep apnea-state-of-the-art annotation of uvulopalatopharyngoplasty. Biomedical Journal. 2023;46(3):100568.
16. Li H-Y. Updated Palate Surgery for Obstructive Sleep Apnea. In: Lin HC, editor. Sleep-Related Breathing Disorders. 80: S.Karger AG; 2017. p. 0.