Effects of transverse maxillomandibular distraction osteogenesis on obstructive sleep apnea syndrome and on the pharynx
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To assess the effects of transverse maxillomandibular distraction osteogenesis (TMDO) on the treatment of obstructive sleep apnea (OSA) and on the morphology of the pharynx.
A clinical trial was conducted with seven patients with OSA and with transverse maxillomandibular deficiency, two women and five men aged on average 41.16 ± 10.9 years on the day of surgery. All participants were submitted to computed tomography (CT) and full-night polysomnography (PSG) before and approximately 9 months after surgery. A 95% confidence interval was defined.
The AHI and RDI of the participants were reduced by about 62% (from 27.65 ± 36.65 to 10.73 ± 11.78, p = 0.031 and from 41.21 ± 32.73 to 15.30 ± 13.87, p = 0.015, respectively). The airway showed a surprising mean reduction in volume of 10% (from 5.78 ± 2.53 to 4.71 ± 1.42, p = 0.437, for the upper pharynx; from 6.98 ± 2.23 to 6.23 ± 2.05, p = 0.437, for the lower pharynx; and from 12.76 ± 1.56 to 10.94 ± 2.42, p = 0.625, for the total pharynx). However, the site of the smallest area of the pharynx was considerably increased both in the anteroposterior and transverse direction and in its total area (from 0.88 ± 7.11 to 0.99 ± 0.39, p = 0.625; from 1.78 ± 0.81 to 2.05 ± 0.61, p = 0.812; and from 0.99 ± 0.74 to 1.40 ± 0.51, p = 0.180, respectively).
TMDO proved to be efficient in reducing or curing OSA, producing modifications of upper pharynx morphology with an increase of the smallest area of the pharynx.
KeywordsSurgically assisted rapid maxilla expansion Adults Middle age Sleep apnea syndrome Maxillary transverse distraction osteogenesis Mandibular transverse distraction osteogenesis Maxillomandibular transverse distraction osteogenesis
Transverse maxillomandibular distraction osteogenesis
Transverse maxillary distraction osteogenesis or surgically assisted rapid
Posterior nasal spine
Obstructive sleep apnea
This study received financial support from FAPESP (Fundação de Amparo à Pesquisa do Estado de São Paulo), no. 2011.50305-7.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Statement of informed consent
Informed consent was obtained from all individual participants included in the study.
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