Evaluation of the incidence of obstructive sleep apnea in mandibular fracture patients before and after treatment with the STOP-BANG questionnaire.

Background: Mandibular fractures are common injuries, leading to various complications, including obstructive sleep apnea (OSA). The aim of this study was to evaluate the occurrence of OSA in relation to mandibular fracture type before and after treatment using the STOP-BANG questionnaire.

Material and methods: This prospective study was conducted on patients admitted to Shahid Kamyab Hospital from 2022 to 2023 with mandibular fractures. Patients were classified based on the type and location of fracture, age, gender, and cause. The primary predictor variable was the type of mandibular fracture. The primary outcome variable was the occurrence of OSA as measured by the STOP-BANG questionnaire. Secondary outcomes included changes in STOP-BANG scores over time before and after treatment. Covariates were divided into age and gender (demographic), type of surgical treatment, and Body Mass Index (physiologic). Data analyses included comparisons of STOP-BANG scores over multiple time points (pre-fracture [T0], post-fracture [T1], 1 week post-surgery [T2], and 1 month post-surgery [T3]). The results were analyzed using SPSS 16 software, with a significance level set at p-value < 0.05.

Results: In this study, 154 patients were examined. Ninety-five patients had unilateral fractures and 59 patients had bilateral fractures. The study groups were homogeneous in terms of age, gender, surgical method, and Body Mass Index (BMI). In both unilateral and bilateral groups, the average STOP-BANG score changed significantly over time (p<0.001). Pairwise comparisons indicated that the STOP-BANG score significantly increased at all times compared to pre-fracture, but decreased significantly at each subsequent time point after the fracture. The mean STOP-BANG score was significantly higher in the bilateral group compared to the unilateral group at each time point (T1, T2, T3) (p<0.001). The mean changes in STOP-BANG score relative to T0 were significantly greater in the bilateral group compared to the unilateral group (p<0.001).

Conclusions: Mandibular fractures affect respiratory conditions and can lead to OSA. Surgeons should consider the reduction in respiratory space when treating these patients and choose an appropriate treatment plan. Bilateral fractures are more likely to lead to OSA, whereas OSA occurrence was rarely observed in cases of unilateral fractures.