Abstract:
Obstructive sleep apnoea (OSA) is a syndrome with a high burden on public health. Maxillomandibular advancement (MMA) has proven to be a highly effective treatment option. This retrospective analysis evaluated the safety of maxillomandibular advancement with rotation in patients with OSA. A total of 63 patients with OSA were included in this study. Surgical treatment by maxillomandibular advancement was virtually planned based on preoperative cone beam computed tomography (CBCT). A 3D printed guide and a customised implant were used for surgical transfer. The safety of MMA was evaluated based on the necessity of postoperative intermediate care unit (IMCU) stay, duration of stay in hospital, and recording of medical complications. A total of 63.5% of the OSA patients treated by MMA (n = 40/63) were postoperatively transferred from the recovery room directly to the regular ward, while 36.5% of the patients (n = 23/63) stayed on IMCU for at least one night. On average, the length of hospitalisation was four days after surgery. One patient from the ward group and one patient from the IMCU group developed a major complication according to Clavian-Dindo classification grade IV. MMA is a safe surgical procedure. The necessity for postoperative monitoring in an IMCU setting should be based on an individual risk evaluation. However, since major complications can occur, MMA should be performed as an inpatient procedure in a hospital with available intensive medicine care. This study underlines the safety of MMA in OSA patients.
摘要:
阻塞性睡眠呼吸暂停(OSA)是一种对公众健康造成沉重负担的综合征。上颌下颌前移(MMA)已被证明是一种非常有效的治疗选择。这项回顾性分析评估了OSA患者旋转上颌下颌前移的安全性。本研究共纳入63例OSA患者。实际上,根据术前锥形束计算机断层扫描(CBCT)计划通过上颌下颌前移进行手术治疗。3D打印的引导件和定制的植入物用于手术转移。MMA的安全性是根据术后中间监护病房(IMCU)住院的必要性进行评估的。住院时间,记录医疗并发症。经MMA治疗的OSA患者(n=40/63)共有63.5%在术后从恢复室直接转移到常规病房,而36.5%的患者(n=23/63)在IMCU上停留了至少一个晚上。平均而言,住院时间为手术后4天。根据Clavian-Dindo分类IV级,病房组的一名患者和IMCU组的一名患者出现了主要并发症。MMA是一种安全的外科手术。在IMCU设置中进行术后监测的必要性应基于个人风险评估。然而,因为可能会发生严重的并发症,MMA应在有重症监护的医院中作为住院手术进行。这项研究强调了MMA在OSA患者中的安全性。