目的:从最常见的临床可用数据(与患者相关的,多导睡眠图,头影测量,和手术变量)。
方法:这是一项回顾性研究,包括接受MMA治疗中度至重度OSA的连续患者。相关临床,多导睡眠图,头影测量,收集手术变量作为自变量(预测因子).在单变量和多变量分析中评估了独立变量与对MMA的有利手术反应的关联。
结果:在100名患者中(82%为男性;平均年龄50.5岁),平均呼吸暂停低通气指数[AHI]为53.1起事件/h.良好的手术反应率为67%。基于多变量分析,心血管疾病(CVD)患者对MMA的有利反应的几率降低了0.140倍(OR:0.140[0.038,0.513],P=0.003)。中心性呼吸暂停指数(CAI)和后气道上隙(SPAS)每增加1个单位,对MMA做出有利反应的几率分别为0.828和0.724倍(OR:0.828[0.687,0.997],P=0.047;0.724[0.576,0.910],P=0.006),分别。
结论:这项研究的结果表明,当OSA患者具有某些表型特征时,MMA的手术效果可能较差:存在CVD,较高的CAI和较大的SPAS。如果在未来的研究中得到证实,这些变量可以指导患者选择MMA.
To identify potential predictors of surgical response to maxillomandibular advancement (MMA) in patients with obstructive sleep apnea (OSA) from the most common clinically available data (patient-related, polysomnographic, cephalometric, and surgical variables).
This was a retrospective
study comprised of consecutive patients who underwent MMA for moderate to severe OSA. Relevant clinical, polysomnographic, cephalometric, and surgical variables were collected as independent variables (predictors). The association of the independent variables with a favorable surgical response to MMA was assessed in univariate and multivariate analyses.
In 100 patients (82% male; mean age 50.5 years), the mean apnea hypopnea index [AHI] was 53.1 events/h. The rate of favorable surgical response was 67%. Based on multivariate analysis, patients with cardiovascular disease (CVD) had 0.140 times lower odds of a favorable response to MMA (OR: 0.140 [0.038, 0.513], P = 0.003). For each 1-unit increase in central apnea index (CAI) and superior posterior airway space (SPAS), there were 0.828 and 0.724 times lower odds to respond favorably to MMA (OR: 0.828 [0.687, 0.997], P = 0.047; and 0.724 [0.576, 0.910], P = 0.006), respectively.
The findings of this
study suggest that the surgical outcome of MMA may be less favorable when patients with OSA have certain phenotypic characteristics: the presence of CVD, higher CAI and larger SPAS. If confirmed in future studies, these variables may guide patient selection for MMA.