Relationship Between Improvement of Apnea-Hypopnea Index and Maxillofacial Morphology Following Laparoscopic Sleeve Gastrectomy.

Abstract

Purpose: Obesity is the most important factor in obstructive sleep apnea (OSA). Even if metabolic surgery (MS) weight loss is achieved, the therapeutic effect has not been proven for OSA. This study compared the apnea-hypopnea index (AHI) before surgery (T0), 1 year after surgery (T1), and 2 years after surgery (T2), assuming that the effect of MS on the AHI is influenced by the ANB angle (formed by point A, nasion, and point B), which reflects the anteroposterior relationship between the maxilla and mandible. Methods: The study included 47 patients with a body mass index ≥35 kg/m² who underwent MS. To compare the AHI before and after surgery, we classified participants into three groups based on the ANB angle at the initial examination: skeletal Class I (>1° and <4°), II (≥4°), and III (≤1°). Results: The mean AHI of all participants was 56.8 events/hr at T0, 26.5 at T1, and 23.7 at T2. Both postsurgical values were significantly lower than the presurgical value at T0. The mean AHI in skeletal Class I was 19.1 at T1 and 15.1 at T2, which was a significant decrease compared with T0 (50.4). Although the mean AHI was 38.8 at T1 and 38.8 at T2 in the skeletal Class II, which were lower than that at T0 (65.9), no significant difference was observed. The mean AHI was 20.0 at T1 and 15.3 at T2 in the skeletal Class III, which were significantly decreased as compared with that at T0 (53.5). Conclusion: Measuring the ANB angle prior to surgery is useful for predicting the postoperative effect.