Abstract:
Maxillomandibular advancement has been shown to be an effective treatment for obstructive sleep apnea; however, the literature focuses mainly on sleep-related parameters such as apnea-hypopnea index, respiratory disturbance index and Epworth sleepiness scale. Other factors that may be important to patients, such as esthetics, patient satisfaction, nasality, swallowing problems and so forth have been reported in the literature but have not been systematically studied. Together with an information specialist, an extensive search in Medline, Embase and Scopus yielded 1592 unique articles. Titles and abstracts were screened by two blinded reviewers. In total, 75 articles were deemed eligible for full-text screening and 38 articles were included for qualitative synthesis. The most common categories of non-sleep related outcomes found were surgical accuracy, facial esthetics, functional outcomes, quality of life, patient satisfaction, and emotional health. All categories were reported using heterogenous methods, such that meta-analysis could not be performed. There was lack of consistent methods to assess these outcomes. This work is the first to systematically review non-sleep related outcomes of maxillomandibular advancement. Despite growing interest in evaluating surgical outcomes through patient subjective experiences, this review points to the need of standardized, validated methods to report these outcomes.
摘要:
上颌下颌前移已被证明是阻塞性睡眠呼吸暂停的有效治疗方法;然而,文献主要集中在睡眠相关参数,如呼吸暂停低通气指数,呼吸障碍指数和Epworth嗜睡量表。其他可能对患者很重要的因素,比如美学,患者满意度,鼻性,吞咽问题等已在文献中报道,但尚未系统研究。与信息专家一起,在Medline进行了广泛的搜索,Embase和Scopus产生了1592篇独特文章。标题和摘要由两名失明的审稿人筛选。总的来说,75篇文章被认为符合全文筛选的条件,38篇文章被纳入定性综合。发现的最常见的非睡眠相关结局类别是手术准确性,面部美学,功能结果,生活质量,患者满意度,和情绪健康。所有类别均使用异质方法报告,因此无法进行荟萃分析。缺乏评估这些结果的一致方法。这项工作是第一个系统地回顾上颌下颌前移的非睡眠相关结果。尽管人们对通过患者主观经验评估手术结果的兴趣日益浓厚,这次审查指出了标准化的必要性,经过验证的方法来报告这些结果。