Abstract
Upper airway changes following bimaxillary advancement surgery to treat obstructive sleep apnea syndrome remain controversial. The main objective of this systematic review and meta-analysis was to investigate the effects of bimaxillary advancement surgery on the upper airway (UA) of obstructive sleep apnea syndrome patients through examining changes three-dimensionally in vertical and supine position and through changes in oximetric variables (AHI, RDI, O2 Sat) and in the quality of life measured by the Epworth sleepiness scale (ESS). A thorough search of the PubMed, Scopus, Embase and Cochrane databases and a grey literature search (Opengrey) were conducted. No limit was placed on publication year or language. The inclusion criteria were: adult obstructive sleep apnea patients who had undergone bimaxillary advancement surgery, three-dimensional CBCT or CT and oximetric measurements and at least six weeks follow-up. Sample sizes of under 10 patients were excluded. Finally, 26 articles were included in the qualitative review and 23 in the meta-analysis. Bimaxillary advancement surgery has been shown to be beneficial in terms of increased upper airway size, improved oximetric indicators and the quality of life measured on the Epworth sleepiness scale.
Highlights
The main objective of this systematic review and meta-analysis was to investigate the effects of bimaxillary advancement surgery on the upper airway (UA) of patients with obstructive sleep apnea syndrome
The search identified 2979 preliminary references related to changes in the airway following orthognathic surgery, of which 1410 were found in Pubmed, 640 in Scopus, 4 in Cochrane, 908 in Embase, 13 in the grey literature search and 4 through hand-searching based on the references cited in the articles included
After examining the full text of the resulting 53 articles, 27 were excluded for the following reasons: 13 did not answer the PICO question, 7 only examined the UA two-dimensionally, 5 were narrative reviews or letters to the editor, 1 included patients aged under 18 years and 1 had a sample size of fewer than 10 patients
Summary
The main objective of this systematic review and meta-analysis was to investigate the effects of bimaxillary advancement surgery on the UA of patients with obstructive sleep apnea syndrome. Three-dimensional examination in vertical and in supine position and changes in oximetric variables (AHI, RDI, O2 Sat) and in the patient’s quality of life, measured on the Epworth sleepiness scale (ESS)
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