Comparison of phenotypic characteristics between responders and non-responders to treatment for obstructive sleep apnea with maxillomandibular advancement in adults

IF 3.8 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine Pub Date : 2025-03-12 DOI:10.1016/j.sleep.2025.03.006

Khang Huy Thai , Ying-An Chen , Chuan-Fong Yao , Ning-Hung Chen , Yu-Fang Liao , Yu-Ray Chen

{"title":"Comparison of phenotypic characteristics between responders and non-responders to treatment for obstructive sleep apnea with maxillomandibular advancement in adults","authors":"Khang Huy Thai , Ying-An Chen , Chuan-Fong Yao , Ning-Hung Chen , Yu-Fang Liao , Yu-Ray Chen","doi":"10.1016/j.sleep.2025.03.006","DOIUrl":null,"url":null,"abstract":"<div><h3>Background and objective</h3><div>3D cone-beam computed tomography (CBCT) images obtained presurgery and postsurgery can expand our knowledge of predictors of successful maxillomandibular advancement (MMA) for treatment of adult patients with obstructive sleep apnea (OSA). This prospective cohort study aimed to identify predictors of successful MMA surgery for adults with OSA using anatomical CBCT measurements.</div></div><div><h3>Methods</h3><div>Analysis of anatomical outcomes was conducted by comparing postoperative with preoperative measures from 3D CBCT images. Preoperative and postoperative variables of responders were compared with non-responders. A postoperative AHI <10 and a reduction of >50 % identified responders.</div></div><div><h3>Results</h3><div>A total of 50 patients met the inclusion criteria. The mean (SD) AHI was 32.3 (21.0). The mean (SD) age was 32.4 (9.2) years; 72 % were male; mean (SD) body mass index was 22.4 (3.2) kg/m<sup>2</sup>. Mean (SD) time of follow-up was 2.0 (1.5) years. Thirty participants were identified as responders. Compared with preoperative characteristics of non-responders, AHI was significantly lower, the maxilla was shorter, the hyoid position was higher and more forward, tongue and soft palate were shorter, and oropharyngeal airway space was wider and larger (all <em>p</em> < .05). Multivariate logistic regression revealed preoperative variables of maxillary and mandibular width, tongue length, airway length, oropharyngeal anteroposterior dimension, and the surgical variable for degree of mandibular advancement were predictors of successful treatment of OSA with MMA.</div></div><div><h3>Conclusions and relevance</h3><div>Our findings suggest preoperative anatomical characteristics, as well as required surgical advancement should be evaluated when considering MMA for treatment of adults with OSA. The application of 3D CBCT provided detailed information on anatomical characteristics that should be an essential tool when evaluating adult patients with OSA who will benefit from treatment with MMA.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"129 ","pages":"Pages 346-353"},"PeriodicalIF":3.8000,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Sleep medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1389945725001236","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background and objective

3D cone-beam computed tomography (CBCT) images obtained presurgery and postsurgery can expand our knowledge of predictors of successful maxillomandibular advancement (MMA) for treatment of adult patients with obstructive sleep apnea (OSA). This prospective cohort study aimed to identify predictors of successful MMA surgery for adults with OSA using anatomical CBCT measurements.

Methods

Analysis of anatomical outcomes was conducted by comparing postoperative with preoperative measures from 3D CBCT images. Preoperative and postoperative variables of responders were compared with non-responders. A postoperative AHI <10 and a reduction of >50 % identified responders.

Results

A total of 50 patients met the inclusion criteria. The mean (SD) AHI was 32.3 (21.0). The mean (SD) age was 32.4 (9.2) years; 72 % were male; mean (SD) body mass index was 22.4 (3.2) kg/m². Mean (SD) time of follow-up was 2.0 (1.5) years. Thirty participants were identified as responders. Compared with preoperative characteristics of non-responders, AHI was significantly lower, the maxilla was shorter, the hyoid position was higher and more forward, tongue and soft palate were shorter, and oropharyngeal airway space was wider and larger (all p < .05). Multivariate logistic regression revealed preoperative variables of maxillary and mandibular width, tongue length, airway length, oropharyngeal anteroposterior dimension, and the surgical variable for degree of mandibular advancement were predictors of successful treatment of OSA with MMA.

Conclusions and relevance

Our findings suggest preoperative anatomical characteristics, as well as required surgical advancement should be evaluated when considering MMA for treatment of adults with OSA. The application of 3D CBCT provided detailed information on anatomical characteristics that should be an essential tool when evaluating adult patients with OSA who will benefit from treatment with MMA.

查看原文本刊更多论文

背景和目的术前和术后获得的三维锥束计算机断层扫描（CBCT）图像可以扩展我们对阻塞性睡眠呼吸暂停（OSA）成人患者上颌下颌前突矫正术（MMA）成功治疗预测因素的了解。这项前瞻性队列研究的目的是利用 CBCT 解剖学测量方法确定 OSA 成人患者上颌下颌前移术成功的预测因素。方法通过比较三维 CBCT 图像的术后和术前测量结果，对解剖学结果进行分析。将有反应者与无反应者的术前和术后变量进行比较。结果共有 50 名患者符合纳入标准。平均（标清）AHI 为 32.3（21.0）。平均（标清）年龄为 32.4 (9.2) 岁；72% 为男性；平均（标清）体重指数为 22.4 (3.2) kg/m2。平均（标清）随访时间为 2.0 (1.5) 年。30名参与者被确定为应答者。与非应答者的术前特征相比，应答者的 AHI 明显降低，上颌骨变短，舌骨位置变高且更靠前，舌头和软腭变短，口咽气道空间变宽且变大（均为 p <.05）。多变量逻辑回归显示，上颌和下颌宽度、舌长度、气道长度、口咽前后尺寸等术前变量以及下颌前突程度的手术变量是用 MMA 成功治疗 OSA 的预测因素。三维 CBCT 的应用提供了详细的解剖特征信息，这应该成为评估将从 MMA 治疗中获益的 OSA 成人患者的重要工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Sleep medicine 医学-临床神经学

CiteScore

8.40

自引率

6.20%

发文量

1060

审稿时长

49 days

期刊介绍： Sleep Medicine aims to be a journal no one involved in clinical sleep medicine can do without. A journal primarily focussing on the human aspects of sleep, integrating the various disciplines that are involved in sleep medicine: neurology, clinical neurophysiology, internal medicine (particularly pulmonology and cardiology), psychology, psychiatry, sleep technology, pediatrics, neurosurgery, otorhinolaryngology, and dentistry. The journal publishes the following types of articles: Reviews (also intended as a way to bridge the gap between basic sleep research and clinical relevance); Original Research Articles; Full-length articles; Brief communications; Controversies; Case reports; Letters to the Editor; Journal search and commentaries; Book reviews; Meeting announcements; Listing of relevant organisations plus web sites.