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Counter Clockwise Rotational Orthognathic Surgery for the Obstructive Sleep Apnea in Class II Dentofacial Deformity: Polysomnography and 3D Computed Tomographic Analysis

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Abstract
Traditionally, maxillomandibular advancement is an orthognathic surgical procedure that has been used to manage obstructive sleep apnea in patients not able or willing to maintain adherence to continuous positive airway pressure therapy or for patient who are not able to adhere to treatment. However, maxillomandibular advancement often leads to unsatisfactory cosmetic results.This prospective study investigated functional and esthetic outcomes using polysomnography and 3-dimensional computed tomography, after counterclockwise rotational orthognathic surgery. We enrolled 17 patients with obstructive sleep apnea, who underwent orthognathic surgery at single institution between March 2013 and December 2018.After 12 months, the patients' mean self-rated score for facial appearance, using a 10-step visual analog scale, was 7.36. The preoperative apnea-hypopnea index and respiratory disturbance index were 34.70 and 37.45, respectively; postoperative indices were 11.60 and to 12.69, respectively (P = 0.003, 0.003). The mean posterior pharyngeal airway space increased from 5357.88 mm3 preoperatively to 8481.94 mm3 after 6 postoperative months.Counterclockwise rotational orthognathic surgery for the correction of obstructive sleep apnea turned out to be the ideal solution not only in the correction of the sleep apnea, but also in the facial esthetics.

Copyright ⓒ 2020 Wolters Kluwer Health, Inc. All rights reserved.

Conflict of interest statement
Conflicts of interest and sources of funding: This study was supported by a grant (2012-0676) from the Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea. The authors declare no conflict of interest.
Author(s)
강민규이장열정우식정유삼최종우
Issued Date
2021
Type
Article
Keyword
AnalysisMedical collegesSleep apnea syndromesSurgeryPlastic
DOI
10.1097/SAP.0000000000002580
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7553
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2471532905&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Counter%20Clockwise%20Rotational%20Orthognathic%20Surgery%20for%20the%20Obstructive%20Sleep%20Apnea%20in%20Class%20II%20Dentofacial%20Deformity:%20Polysomnography%20and%203D%20Computed%20Tomographic%20Analys&offset=0&pcAvailability=true
Publisher
ANNALS OF PLASTIC SURGERY
Location
미국
Language
영어
ISSN
0148-7043
Citation Volume
86
Citation Number
6
Citation Start Page
640
Citation End Page
646
Appears in Collections:
Medicine > Medicine
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