Maxillary transverse distraction osteogenesis for the treatment of OSAS

Abstract

Introduction Obstructive Sleep Apnea Syndrome (OSAS) is a progressive disease with numerous associated comorbidities. Because of its multifactorial etiology, several treatments have been proposed, not always achieving ideal results. The objective of the present study was to present a new form of treatment for OSAS based on maxillary transverse distraction osteogenesis (MTDO). Materials and methods A prospective study was conducted on 15 individuals with OSAS and with posterior crossbite. Because of atresia of the upper dental arch, the patients were submitted to MTDO, commonly called surgically assisted rapid maxillary expansion (SARME), with osteotomy of the pterygomaxillary suture. After removal of the intraoral distractor, a new polysomnography exam was performed nine months after surgery for the assessment of respiratory sleep disorders. Results Partial results demonstrated a significant reduction of the respiratory disturbance index (RDI) from 27.85 to 12.84, SD 6.46 ( p = 0.003). The apnea-hypopnea index (AHI) was also significantly reduced and oxymetry values showed important improvement. Conclusion MTDO was efficient in reducing or even eliminating OSAS in individuals with atresia of the upper dental arch, thus representing a valid therapy for the treatment of this group of patients, alone or in combination with other surgical techniques such as bimaxillary advancement. Acknowledgements FAPESP.