Abstract：
OBJECTIVE: Maxillomandibular advancement (MMA) is an effective surgical treatment for obstructive sleep apnea (OSA); however, it is unclear how many patients who are referred for MMA actually undergo surgery. This study aims to determine follow-up rates for patients referred for MMA and the reasons behind their choices.
METHODS: Via retrospective review, we assessed consecutive patients with OSA intolerant to continuous positive airway pressure (CPAP) who underwent drug induced sleep endoscopy (DISE) between 2018 and 2020 at our institution. Patients recommended for MMA based on DISE and other findings were included. Patients were then contacted and administered an IRB-approved survey in present time.
RESULTS: One hundred and fifty nine patients were referred to oral maxillofacial surgery (OMFS) for MMA consult. Seventy seven patients (48%) followed up with OMFS and 29 (18%) underwent MMA. Sixty two (40%) patients resumed CPAP. Fifty eight patients (36.5%) were lost to follow up. Seventy three patients (46%) completed our survey. Of those patients, 37 (51%) followed up with OMFS and 17 (23%) underwent MMA. Patients who did not follow up with OMFS cited the invasiveness of the surgery (39%), recovery time (17%), or both (31%) as reasons. Those who pursued consultation cited inability to tolerate CPAP (73%), not being a candidate for inspire (14%), and desire to learn about alternative treatments (14%) as reasons. Of those who did not undergo MMA, 28.6% are not using OSA treatment.
CONCLUSIONS: Less than half of patients referred for MMA followed up, and less than half of those patients underwent MMA. Most patients cited concerns about the invasiveness of the surgery and recovery process.
METHODS: 4 Laryngoscope, 134:2964-2969, 2024.
METHODS: Via retrospective review, we assessed consecutive patients with OSA intolerant to continuous positive airway pressure (CPAP) who underwent drug induced sleep endoscopy (DISE) between 2018 and 2020 at our institution. Patients recommended for MMA based on DISE and other findings were included. Patients were then contacted and administered an IRB-approved survey in present time.
RESULTS: One hundred and fifty nine patients were referred to oral maxillofacial surgery (OMFS) for MMA consult. Seventy seven patients (48%) followed up with OMFS and 29 (18%) underwent MMA. Sixty two (40%) patients resumed CPAP. Fifty eight patients (36.5%) were lost to follow up. Seventy three patients (46%) completed our survey. Of those patients, 37 (51%) followed up with OMFS and 17 (23%) underwent MMA. Patients who did not follow up with OMFS cited the invasiveness of the surgery (39%), recovery time (17%), or both (31%) as reasons. Those who pursued consultation cited inability to tolerate CPAP (73%), not being a candidate for inspire (14%), and desire to learn about alternative treatments (14%) as reasons. Of those who did not undergo MMA, 28.6% are not using OSA treatment.
CONCLUSIONS: Less than half of patients referred for MMA followed up, and less than half of those patients underwent MMA. Most patients cited concerns about the invasiveness of the surgery and recovery process.
METHODS: 4 Laryngoscope, 134:2964-2969, 2024.
摘要：
目的：上颌下颌前移术（MMA）是治疗阻塞性睡眠呼吸暂停（OSA）的有效手术方法；然而，目前尚不清楚有多少转诊为MMA的患者实际接受了手术治疗.这项研究旨在确定MMA患者的随访率以及他们选择的原因。
方法：通过回顾性回顾，我们评估了2018年至2020年间在我们机构接受药物诱导睡眠内窥镜检查(DISE)的连续OSA不耐受持续气道正压(CPAP)的患者.包括基于DISE和其他发现的推荐用于MMA的患者。然后联系患者并在目前进行IRB批准的调查。
结果：一百五十九名患者被转诊至口腔颌面外科（OMFS）进行MMA会诊。77例患者（48％）接受了OMFS随访，29例（18％）接受了MMA。62例（40％）患者恢复了CPAP。58例患者（36.5％）失访。73名患者(46%)完成了我们的调查。这些病人中,37例（51%）接受OMFS随访，17例（23%）接受MMA随访。未接受OMFS随访的患者引用了手术的侵入性（39％），恢复时间（17%），或两者（31％）作为原因。进行咨询的人表示无法容忍CPAP（73％），不是激励的候选人(14%)，和渴望了解替代疗法(14%)的原因。在那些没有接受MMA的人中，28.6%不使用OSA治疗。
结论：接受MMA随访的患者不到一半，不到一半的患者接受了MMA。大多数患者对手术的侵入性和恢复过程表示担忧。
方法：4喉镜，134:2964-2969,2024.
方法：通过回顾性回顾，我们评估了2018年至2020年间在我们机构接受药物诱导睡眠内窥镜检查(DISE)的连续OSA不耐受持续气道正压(CPAP)的患者.包括基于DISE和其他发现的推荐用于MMA的患者。然后联系患者并在目前进行IRB批准的调查。
结果：一百五十九名患者被转诊至口腔颌面外科（OMFS）进行MMA会诊。77例患者（48％）接受了OMFS随访，29例（18％）接受了MMA。62例（40％）患者恢复了CPAP。58例患者（36.5％）失访。73名患者(46%)完成了我们的调查。这些病人中,37例（51%）接受OMFS随访，17例（23%）接受MMA随访。未接受OMFS随访的患者引用了手术的侵入性（39％），恢复时间（17%），或两者（31％）作为原因。进行咨询的人表示无法容忍CPAP（73％），不是激励的候选人(14%)，和渴望了解替代疗法(14%)的原因。在那些没有接受MMA的人中，28.6%不使用OSA治疗。
结论：接受MMA随访的患者不到一半，不到一半的患者接受了MMA。大多数患者对手术的侵入性和恢复过程表示担忧。
方法：4喉镜，134:2964-2969,2024.
