上颌下颚推进手术治疗的阻塞性睡眠呼吸暂停患者报告的结果与健康相关的生活质量：一项系统回顾和荟萃分析

IF 2.3 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral and Maxillofacial Surgery Pub Date : 2025-05-01 DOI:10.1016/j.joms.2025.01.010

Haya H.R. Al-Bayyati , Gert-Jan Hassing MD, DDS, PhD , Egbert P. van der Hoeve MD, DDS , Laurens Koppendraaier MD, DDS , Maurits H.T. de Ruiter MD, DDS, PhD

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引用次数: 0

摘要

目的：上颌下颌突进（MMA）手术治疗阻塞性睡眠呼吸暂停（OSA）的客观指标显示其有效；然而，患者报告的结果测量（PROMs），特别是与健康相关的生活质量（HRQoL）也很重要，但尚未系统地评估与MMA手术治疗OSA的关系。因此，本研究旨在以OSA患者HRQoL为重点，对MMA手术对PROMs的影响进行系统综述。方法：根据系统评价和荟萃分析指南的首选报告项目进行系统评价和荟萃分析，并在PubMed和Medline进行文献检索，以确定从数据库建立到2024年5月评估PROMs的相关研究，重点关注MMA手术治疗的成人OSA患者的HRQoL。主要变量是prom的结果。根据系统评价和meta分析框架的首选报告项目进行筛选和合格性评估，并使用ROBINS-I工具评估研究质量。荟萃分析的数据提取包括PROMs结果，并在SPSS中使用固定效应模型报告效应大小为平均差异。结果：33项研究被筛选，其中12项纳入本系统综述，涵盖317例患者。这些研究以不同的方式报道了PROMs，但MMA一致显示出术后平均差异的改善。在最常用的PROMs器械中，MMA手术与Epworth嗜睡量表的5.35点改善相关(95% CI -6.57至-4.14；z = -8.62；结论：阻塞性睡眠呼吸暂停患者行MMA手术可显著改善与生活质量相关的PROMs。prom是积极的，显示了各个领域的满意度。这表明MMA手术得到了患者的好评，并导致与HRQoL相关的PROMs有临床意义的改善。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Patient-Reported Outcomes With Focus on Health-Related Quality of Life in Patients With Obstructive Sleep Apnea Treated With Maxillomandibular Advancement Surgery: A Systematic Review and Meta-Analysis

Purpose

Maxillomandibular advancement (MMA) surgery for obstructive sleep apnea (OSA) has shown to be effective according to objective measures; however, patient-reported outcome measures (PROMs), especially health-related quality of life (HRQoL), are also crucial but have not been systematically assessed in relation to MMA surgery for OSA yet. Therefore, this study aims to conduct a systematic review on the effect of MMA surgery on PROMs focusing on HRQoL in patients with OSA.

Methods

A systematic review and meta-analysis were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines with a literature search performed in PubMed and Medline to identify relevant studies from database inception to May 2024 evaluating PROMs focusing on HRQoL in adult OSA patients treated with MMA surgery. The primary variables are the PROMs outcomes. Screening and eligibility assessments were carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis framework, and study quality was evaluated using the ROBINS-I tool. The data extraction for the meta-analysis included PROMs outcomes and was carried out in SPSS using a fixed-effects model to report effect sizes as mean differences.

Results

Thirty-three studies were screened of which 12 were included in this systematic review encompassing 317 patients. The studies reported PROMs in a heterogeneous manner, but MMA consistently showed an improvement postoperatively in mean differences. In the most used PROMs instruments MMA surgery was associated with a 5.35-point improvement in the Epworth Sleepiness Scale (95% CI −6.57 to −4.14; Z = −8.62; P < .001), a 3.96-point improvement on the Functional Outcomes of Sleep Questionnaire (95% CI 3.11, 4.80; Z = 11.60; P < .001) and an improvement in all domains of the Short Form 36 Health Survey.

Conclusion

MMA surgery for patients with OSA shows significant improvements in PROMs related to quality of life. The PROMs are positive, demonstrating satisfaction across various domains. This indicates that MMA surgery is well received by patients and results in clinically meaningful improvements in PROMs related to HRQoL.

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来源期刊

Journal of Oral and Maxillofacial Surgery 医学-牙科与口腔外科

CiteScore

4.00

自引率

5.30%

发文量

审稿时长

41 days

期刊介绍： This monthly journal offers comprehensive coverage of new techniques, important developments and innovative ideas in oral and maxillofacial surgery. Practice-applicable articles help develop the methods used to handle dentoalveolar surgery, facial injuries and deformities, TMJ disorders, oral cancer, jaw reconstruction, anesthesia and analgesia. The journal also includes specifics on new instruments and diagnostic equipment and modern therapeutic drugs and devices. Journal of Oral and Maxillofacial Surgery is recommended for first or priority subscription by the Dental Section of the Medical Library Association.