The effect of maxillary-mandibular advancement surgery on two-dimensional cephalometric analysis, polysomnographic and patient-reported outcomes in 32 patients with sleep disordered breathing: A retrospective cohort study

Abstract

This retrospective study evaluated the effect of bimaxillary advancement surgery on pre- and postoperative 2D cephalometric soft- and hard tissue measurements, polysomnography (PSG) and patient-reported snoring scores including Epworth sleepiness scale (ESS) after multidisciplinary treatment planning in 32 patients with obstructive sleep apnea or sleep disordered breathing (OSAS/SDB). Apnea-hypopnea index significantly improved with a mean difference of 18.32 ± 13.97 (P = 0.004). ESS, snoring intensity and snoring severity scores all significantly improved after surgery. The preoperative surgical planning was achieved based on 2D pre- and postoperative cephalometric comparison. Most 2D cephalometric measurements did not correlate with postoperative PSG findings. Amount of maxillary and mandibular advancement measured on 2D cephalograms did correlate with postoperative time below 88% oxygen saturation on PSG. In conclusion: bimaxillary advancement surgery has clinically significant favourable results in patients with OSAS/SDB both measured by PSG and with patient-reported outcomes after careful multidisciplinary treatment planning. Current 2D cephalometric airway analysis insufficiently predicted the effect of maxillomandibular advancement surgery in patients with OSAS/SDB.