Abstract
AbstractObjectiveTo provide an updated evaluation of clinical effectiveness and sequelae of maxillomandibular advancement surgery in obstructive sleep apnea.Data SourcesPubMed, Scopus, CINAHL.Review MethodsIncluded studies described patients with obstructive sleep apnea that completed maxillomandibular advancement with any reported sequelae. Meta‐analysis of proportions, regressions, and single means with 95% confidence interval were calculated using random and fixed effects models.ResultsOf 380 unique abstracts reviewed, a total of 31 studies (n = 1597) were included in meta‐analysis. Maxillomandibular advancement patients showed significant improvements in apnea‐hypopnea index (AHI), respiratory disturbance index (RDI), SpO2 Nadir, Epworth sleepiness scale (ESS), and body‐mass index (BMI) by −41.87/h [−49.86 to −33.89], −46.24/h [−62.18 to −30.29], 6.29% [3.42 to 12.08], −8.69 [−11.54 to −5.83], and −0.74 kg/m2 [−1.35 to −0.12], respectively. Sequelae with the greatest incidence were early lower facial numbness (83.40%), late lower facial numbness at less and greater than 1 year follow‐up (66.51%, 32.73% respectively), and hardware removal (21.99%). There was a positive correlation between both preoperative BMI and length of hospital stay (r = 0.81, P = .052) and age and lower facial numbness (r = 0.42, P = .196). A negative correlation was found between Change in AHI and time to follow up (r = 0.75, P = .087). No major complications nor mortality were reported.ConclusionMaxillomandibular advancement has the highest success rate for obstructive sleep apnea among current surgical treatments, with most sequelae being transient. Early lower facial numbness should be highlighted preoperatively to ensure informed decision‐making. Further research should be geared towards reducing this risk.
Published Version
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