Abstract：
This systematic review aimed to investigate the factors that may contribute to the development of OSA after orthognathic surgery in patients with skeletal class III. Electronic searches of PubMed, Embase, Web of Science, and Cochrane databases were conducted up to December 10, 2022. In total, 277 studies were retrieved and screened according to the inclusion and exclusion criteria, and 14 were finally selected. All studies were of medium quality (moderate risk of bias). The occurrence of OSA after orthognathic surgery in patients with class III skeletal relationships depends on surgical factors and patient self-factors. Surgical factors include surgery type, amount of maxillary and mandibular movement, and the patient\'s postoperative swelling. Patient self-factors include weight, age, gender, and hypertrophy of the soft palate, tonsils, and tongue. According to information in the 14 selected articles, the incidences of OSA after Le Fort I impaction and BSSO setback, BSSO setback, and Le Fort I advancement and BSSO setback were 19.2%, 8.57%, and 0.7%, respectively, mostly accompanied with greater amounts of mandibular recession. However, no clear evidence exists to confirm that orthognathic surgery is a causative factor for postoperative sleep breathing disorders in patients with mandibular prognathism. The wider upper airway in patients with class III skeletal might be the reason for the rare occurrence of OSA after surgery. In addition, obesity and advanced age may lead to sleep apnea after orthognathic surgery. Obese patients should be advised to lose weight preoperatively.
摘要：
这项系统评价旨在研究可能导致骨骼III类患者正颌手术后OSA发展的因素。PubMed的电子搜索，Embase,WebofScience,和Cochrane数据库进行到2022年12月10日。总的来说,根据纳入和排除标准检索和筛选277项研究，14人最终被选中。所有研究均为中等质量（中度偏倚风险）。III类骨骼关系患者正颌手术后OSA的发生取决于手术因素和患者自身因素。手术因素包括手术类型，上颌和下颌运动量，病人术后肿胀.患者自身因素包括体重，年龄,性别,软腭肥大,扁桃体,和舌头。根据14篇精选文章中的信息，LeFortI撞击和BSSO挫折后OSA的发生率，BSSO挫折，LeFortI推进和BSSO挫折为19.2%，8.57%，和0.7%，分别,大多伴有更大量的下颌衰退。然而,没有明确的证据证实正颌手术是下颌前颌畸形患者术后睡眠呼吸障碍的原因.III类骨骼患者上呼吸道较宽可能是术后OSA罕见发生的原因。此外,肥胖和高龄可能导致正颌手术后的睡眠呼吸暂停。建议肥胖患者术前减肥。
