Factors related to oxygen desaturation index during sleep 7days after bilateral sagittal splitting ramus osteotomy in patients without previous obstructive sleep apnea.

Abstract

The incidence of obstructive sleep apnea (OSA) immediately after surgery in patients with dentofacial deformities without previous OSA remains unknown. We aimed to perioperatively evaluate factors associated with oxygen desaturation index (ODI) during sleep, 7days after bilateral splitting ramus osteotomy (BSSRO) in patients without previous OSA. Fifty-one patients (15 males, 36 females) with dentofacial deformities, scheduled to undergo BSSRO, were included. Polysomnography was performed before orthognathic surgery. Perioperative OSA was evaluated with peripheral arterial tonometry on the day of surgery and 1, 2, 3, 4, and 7days postoperatively. Rapid eye movement (REM) sleep periods and the ODI were measured. Factors associated with perioperative ODI after surgery were statistically analyzed. REM sleep periods were significantly decreased on the day of surgery and significantly increased at 4 and 7days postoperatively, compared to the preoperative period. ODI increased on the day of surgery, decreased after 1day, and increased again at 4 and 7days postoperatively. ODI on the day of surgery was significantly increased due to increased preoperative ODI, overjet, and SN-MP angle and decreased SNA and SNB angle. ODI at 7days postoperatively was significantly increased due to increased REM sleep periods and decreased SN-MP and gonial angle. ODI was increased in response to REM sleep periods 7days after BSSO. Airway management in patients with dentofacial deformity should be given more attention by preoperative assessment for OSA, even in the absence of previous OSA, until 7days postoperatively due to REM rebound.