Does orthognathic surgery have an incidentally beneficial effect on mild or asymptomatic sleep apnoea?

Abstract

A prospective study was performed to assess the effect of orthognathic surgery on mild obstructive sleep apnoea (OSA) in patients with an underlying dentofacial deformity treated for occlusal and/or aesthetic reasons. As the main outcome variables, changes in upper airway volume and apnoea–hypopnoea index (AHI) were evaluated at 1 and 12 months of follow-up, in patients undergoing orthognathic surgery with widening movements of the maxillomandibular complex. Descriptive, bivariate, and correlation analyses were performed; significance was set at P < 0.05. Eighteen patients diagnosed with mild OSA were enroled (mean age 39.8 ± 10.0 years). An overall upper airway volume widening of 46.7% after orthognathic surgery was observed at 12 months of follow-up. The AHI decreased significantly from a median 7.7 events/hour preoperatively to 5.0 events/h at 12 months postoperative (P = 0.045), and the Epworth Sleepiness Scale score decreased from a median 9.5 preoperatively to 7 at 12 months postoperative (P = 0.009). A cure rate of 50% was obtained at 12 months of follow-up (P = 0.009). Despite the limited sample size, this study provides evidence that in patients with an underlying retrusive dentofacial deformity and mild OSA, a slight decrease in AHI is obtained after orthognathic surgery due to upper airway enlargement, which could be added as a beneficial effect of orthognathic surgery.