Surgery that moves the jaws forward can result in significant improvements in long-term quality of life – including functional outcomes and sleep quality – in patients with obstructive sleep apnea (OSA), according to a new study.
Researchers analyzed long-term quality of life factors in patients who underwent jaw surgery – known as maxillomandibular advancement (MMA) – which helps open the airway to treat severe OSA, according to the study in the January issue of the Journal of Oral and Maxillofacial Surgery, the official journal of the American Association of Oral and Maxillofacial Surgeons (AAOMS).
During OSA, airway muscles, large tonsils, the tongue or excess tissue blocks the airway – leading to breathing stopping and starting during sleep. The condition can result in excessive daytime sleepiness, lower quality of life and impaired cognitive function that affects daily activities.
The study’s 27 patients underwent follow-up examination for at least five years and at an average of nearly 13 years. They answered a questionnaire that asked about sleep quality, daytime function as well as physical, mental, emotional and sexual health.
Among the results, 88 percent of patients said they snored less, 82 percent said their sleep quality improved and 77 percent said they experienced less difficulty remaining awake during the day. Patients also expressed contentment with the surgery: 76 percent were satisfied MMA managed their OSA, 71 percent would undergo MMA again to treat their OSA and 65 percent said they would recommend MMA to other OSA patients.
Patients also said they felt their speech quality or swallowing ability did not change, they experienced bearable pain after surgery, and they had a satisfactory facial appearance.
“The most significant subjective improvements were in the specific categories of personal satisfaction, sleep quality and functional outcomes,” researchers wrote. “These data tend to indicate that very long-term subjective improvements in (quality of life) issues from MMA for OSA are possible.”
No significant improvement or change occurred in some categories – including physical health and sexual desire – but their results could decrease with age even in those who do not undergo surgery, researchers wrote.
The authors of “Maxillomandibular Advancement for Obstructive Sleep Apnea Is Associated With Very Long-Term Overall Sleep-Related Quality-of-Life Improvement” are from Allegheny General Hospital, Division of Oral and Maxillofacial Surgery, Pittsburgh, Pa.: Joseph E. Cillo Jr., DMD, MPH, PhD; Neil Robertson, DMD; and David J. Dattilo, DDS.
The full article can be accessed at JOMS.org/article/S0278-2391(19)30640-8/fulltext.
The Journal of Oral and Maxillofacial Surgery is published by the American Association of Oral and Maxillofacial Surgeons to present to the dental and medical communities comprehensive coverage of new techniques, important developments and innovative ideas in oral and maxillofacial surgery. Practice-applicable articles help develop the methods used to handle dentoalveolar surgery, facial injuries and deformities, TMJ disorders, oral and head and neck cancer, jaw reconstruction, anesthesia and analgesia. The journal also includes specifics on new instruments and diagnostic equipment, and modern therapeutic drugs and devices.
The experts in face, mouth and jaw surgery® — The American Association of Oral and Maxillofacial Surgeons (AAOMS) is the professional organization representing more than 11,000 oral and maxillofacial surgeons, OMS residents and OMS professional staff in the United States. AAOMS supports its fellows’ and members’ ability to practice their specialty through education, research and advocacy. AAOMS fellows and members comply with rigorous continuing education requirements and submit to periodic office anesthesia evaluations. For additional information about oral and maxillofacial surgery, visit the AAOMS websites at AAOMS.org and MyOMS.org.
