Mandibular Distraction Osteogenesis for the Treatment of an Obstructive Sleep Apnea Patient with Orthognathic Anomaly: A Case Report and Literature Review

Metin Şençimen,Timur Akçam,Fevzi Erdemci,Gürkan Raşit Bayar,Hasan Ayberk Altuğ,Handan Altuğ,Gamze Arıcı

doi:10.4236/crcm.2014.311133

Metin Şençimen, Timur Akçam + Show 5 more

Open Access

https://doi.org/10.4236/crcm.2014.311133

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Journal: Case Reports in Clinical Medicine	Publication Date: Jan 1, 2014
Citations: 23	License type: CC BY 4.0

Abstract

Objective: skeletal advancement in order to improve the airway dimensions is known as one of the most effective surgical theraphy for treating obstructive sleep apnea (OSA). Distraction osteogenesis (DO) can be a better treatment alternative in some selected cases similar to our patient. Using custom made distractors can make this technique more safe and successful. Study Design: Surgically assisted rapid palatal expansion (SARPE), bilateral intraoral mandibular distraction osteogenesis (MDO) and orthodontic treatment were tried to a 20-year-old OSA patient with orthognathic anomaly. For mandibular distraction, custom made distractors were used. Results: The initial AHI of the patient was 23.3. At the end of the treatment it decreased to 8.7. Conclusions: Distraction osteogenesis could be a better alternative than the conventional orthognathic surgery in this kind of selected patients. Customization of the distraction devices can contribute to making this procedure safer and more successful.

Highlights

Obstructive sleep apnea (OSA) is characterized by repetitive episodes of upper airway obstruction (complete How to cite this paper: Şençimen, M., Altuğ, H.A., Akçam, T., Erdemci, F., Bayar, G.R., Altuğ, H. and Arıcı, G. (2014) Mandibular Distraction Osteogenesis for the Treatment of an Obstructive Sleep Apnea Patient with Orthognathic Anomaly: A Case Report and Literature Review
The surgeries limited with the soft tissues usually target only a spesific area of the upper airway but skeletal advancement enlarges the pharyngeal space by expanding the skeletal framework that all the soft-tissue pharyngeal structures and tongue attach to
We presented the treatment of OSA in an adult patient with orthognathic anomaly with surgically assisted rapid palatal expansion (SARPE), bilateral intraoral mandibular distraction osteogenesis and orthodontics

Summary

Introduction

Obstructive sleep apnea (OSA) is characterized by repetitive episodes of upper airway obstruction (complete How to cite this paper: Şençimen, M., Altuğ, H.A., Akçam, T., Erdemci, F., Bayar, G.R., Altuğ, H. and Arıcı, G. (2014) Mandibular Distraction Osteogenesis for the Treatment of an Obstructive Sleep Apnea Patient with Orthognathic Anomaly: A Case Report and Literature Review. (2014) Mandibular Distraction Osteogenesis for the Treatment of an Obstructive Sleep Apnea Patient with Orthognathic Anomaly: A Case Report and Literature Review. OSA is a likely contributor to increased cardiovascular and cerebrovascular morbidity and mortality as well as excessive daytime sleepiness, fatigue, and neurocognitive deficits If it is not treated, the mortality rate for severe OSA is approximately 30% at 15 years [2]. Most of OSA patients suffer from craniofacial abnormalities, such as mandibular hypoplasia and maxillary and mandibular transverse deficiencies. With the deeper recognition of the role of craniofacial abnormalities in the development of OSA, surgically assisted rapid palatal expansion (SARPE) and/or mandibular distraction osteogenesis (MDO) becomes inspiring treatment strategies to correct or improve craniofacial structures of OSA patients. Rapid maxillary expansion can have a beneficial effect on the nasorespiratory pattern in some studies in adolescents [5][7]

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