Changing Practice: Trends in Skeletal Surgery for Obstructive Sleep Apnea

Publication date: Available online 18 December 2018

Source: Journal of Cranio-Maxillofacial Surgery

Author(s): Michael Awad, Christopher Gouveia, Soroush Zaghi, Macario Camacho, Stanley Yung Liu

Objectives

/Hypothesis: The objective of this study was to systematically review the English literature for articles that have described skeletal surgeries in the treatment of obstructive sleep apnea in both adults and children. From these articles trends and patterns in the treatment of OSA with skeletal procedures are described.

Study Design

Three databases including MEDLINE, Google Scholar and the Cochrane Library were searched through May 1, 2018.

Methods

The systematic and independent literature reviews were performed and the determination of included studies was made by consensus. Relevant studies were examined based on six categories of skeletal surgery: 1) Hyoid Advancement 2) Genioplasty/Genioglossus Advancement 3) Maxillary Expansion 4) Maxillomandibular Advancement 5) Mandibular Distraction and 6) Maxillomandibular Expansion.

Results

1875 studies were analyzed for inclusion of which 414 were ultimately included in our analysis. A steady increase in the publication of articles pertaining to maxillary expansion and maxillomandibular advancement was identified. Research interest in hyoid advancement and genioplasty/genioglossus advancement has declined in the past decade.

Conclusions

Changing trends in skeletal surgery for OSA offer exciting and efficacious therapeutic surgical modalities. MMA is the most widely studied and efficacious multi-level surgery for OSA today. Newer modalities such as adult maxillary expansion offer encouraging early results with minimal complication rates, and further study should be directed in this area.

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