The Relationship Between Cephalogram Analysis and Oxygen Desaturation Index During Sleep in Patients Submitted for Mandibular Setback Surgery

J Craniofac Surg. 2018 Jun;29(4):e375-e380. doi: 10.1097/SCS.0000000000004386.

Abstract

Objectives: The aim of this study was to examine the relationship between morphologic factors of mandibular protrusion patients and clinical indices of obstructive sleep apnea (OSA).

Methods: Fifty-two Japanese patients divided into 2 groups: 1 jaw surgery group (30 patients) and 2 jaw surgery group (22 patients). Morphologic changes were studied using cephalograms taken before surgery and 1 year after surgery. Functional changes studied using impulse oscillometry and pulse oximetry during sleep, both of which are clinically useful measures in assessing OSA, taken before surgery and 1 year after surgery.

Result: Lower face cage area significantly decreased in 1 jaw group than in 2 jaw group patients. Positive significant correlation was found between changes in 3% oxygen desaturation index (ODI) and changes of tongue area and vertical position of the hyoid bone in 1 jaw surgery group. Multiple regression analysis indicates that tongue area and airway area were independently significant predictors of 3% ODI in 1 jaw group patients.

Conclusion: In 2 jaw surgery, maxillary surgery compensated for the effect of mandibular setback surgery. Mandibular setback surgery to mandibular protrusion patients was performed within the range of adequate movement distance, but precautions for risk of postoperative obstructive sleep apnea syndrome should be considered.

MeSH terms

  • Adult
  • Cephalometry / methods
  • Female
  • Humans
  • Hyoid Bone / physiology
  • Male
  • Mandible / surgery*
  • Middle Aged
  • Orthognathic Surgical Procedures / methods
  • Oximetry
  • Oxygen / blood*
  • Pharynx / anatomy & histology
  • Sleep / physiology
  • Sleep Apnea, Obstructive / blood
  • Sleep Apnea, Obstructive / physiopathology
  • Sleep Apnea, Obstructive / surgery*
  • Tongue / physiology
  • Young Adult

Substances

  • Oxygen