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DOI: 10.5935/1984-0063.20170029
Surgical treatment of a Pattern I Obstructive Sleep Apnea Syndrome individual - clinical case report
Obstructive Sleep Apnea Syndrome (OSA) is a multifactorial disease that highly alters a persons quality of life. It is characterized by the repeated interruption of breathing during sleep, due to an obstruction or the collapse of the upper airways. Since it is a multifactorial etiological disorder, it requires a thorough diagnosis and treatment with an interdisciplinary team, which comprises several professionals such as a surgical dentist, phonoaudiologist, otorhinolaryngologist, sleep doctor, neurologist and physiotherapist. The diagnosis and the degree of severity of the syndrome is determined through a polysomnography examination. After that, the best form of treatment is devised depending on the gravity of the case. In cases of moderate to severe apnea, invasive treatment through surgical procedures such as maxillomandibular advancement remains the preferred option as it increases the posterior air space, reducing and/or eliminating the obstruction. Thus, improving the patients respiratory function and, consequently, his quality of life as it is shown in the clinical case at hand. In which the male patient, facial pattern type I, 41 years of age, diagnosed with moderate OSA (Apnea-Hypopnea Index - AHI of 23.19), decided to have a surgical treatment instead of a conservative one, resulting in the cure of apnea (AHI of 0.3).
Publication History
Received: 26 June 2017
Accepted: 13 September 2017
Article published online:
11 October 2023
© 2023. Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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REFERENCES
- 1 Spicuzza L, Caruso D, Maria G. Obstructive sleep apnoea syndrome and its management. Ther Adv Chronic Dis. 2015;6(5):273-85.
- 2 Jordan AS, McSharry DG, Malhotra A. Adult obstructive sleep apnoea. Lancet. 2014;383(9918):736-47.
- 3 Libman E, Bailes S, Fichten CS, Rizzo D, Creti L, Baltzan M, et al. CPAP Treatment Adherence in Women with Obstructive Sleep Apnea. Sleep Disord. 2017;2017:2760650.
- 4 Feitoza CC, Azevedo WRS, Emery JMT, Pereira CV, Vargas Jr CS, Pizzol KED. Cirurgia ortognática no tratamento da síndrome da apneia obstrutiva do sono - relato de caso. OrthoScience. 2017;10(38):98-105.
- 5 Epstein LJ, Kristo D, Strollo PJ Jr, Friedman N, Malhotra A, Patil SP, et al.; Adult Obstructive Sleep Apnea Task Force of the American Academy of Sleep Medicine. Clinical guideline for the evaluation, manegement and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med. 2009;5(3):263-76.
- 6 Ferraz O, Guimarães TM, Rossi RR, Cunali PA, Fabbro CD, Chaves CM, et al. Effectiveness of Maxillomandibular advancement (MMA) surgery in sleep apnea treatment: Case report. Sleep Sci. 2016;9(3):134-9.
- 7 Caples SM, Rowley JA, Prinsell JR, Pallanch JF, Elamin MB, Katz SG, et al. Surgical modifications of the upper airway for obstructive sleep apnea in adults: a systematic review and meta-analysis. Sleep 2010;33(10):1396-407.
- 8 Feres MA, Feres R. A Ortodontia no diagnóstico e tratamento da apneia obstrutiva do sono em crianças. OrthoScience. 2013;6(23):410-4.
- 9 Phan NT, Wallwork B, Panizza B. Surgery for adult patients with obstructive sleep apnoea: A review for general practitioners. Aust Fam Physician. 2016;45(8):574-8.
- 10 Al-Moraissi EA, Wolford LM. Is Counterclockwise Rotation of the Mandibular Complex Stable Compared to Clockwise Rotation in the Dentofacial Deformities? A Systematic Review and Meta-Analysis. J Oral Maxillofac Surg. 2016;74(10):2066.e1-2066.e12.
- 11 Mehra P, Downie M, Pita MC, Wolford LM. Pharyngeal airway space changes after counterclockwise rotation of the maxillomandibular complex. Am J Orthod Dentofacial Orthop. 2001;120(2):154-9.
- 12 Capelloza Filho L, Ribeiro AA, Guedes FP, Nary Filho H, Maltagliat LA, Cardoso MA. Tratamento ortodôntico cirúrgico da birretrusão associado à SAOS: relato de caso. OrthoScience. 2012;5(19):311-24.
- 13 Prado BN, Fernandes EG, Moreira TCA, Gavranich Junior J. Apneia Obstrutiva do Sono: Diagnóstico e Tratamento. Rev Odontol Univ Cid São Paulo. 2010;22(3):233-9.
- 14 Okushi T, Tonogi M, Arisaka T, Kobayashi S, Tsukamoto Y, Morishita H, et al. Effect of maxillomandibular advancement on morphology of velopharyngeal space. J Oral Maxillofac Surg. 2011;69(3):877-84.
- 15 La Piana GE, Scartabellati A, Chiesa L, Ronchi L, Raimond P, Carro MA, et al. Long-term adherence to CPAP treatment in patients with obstructive sleep apnea: importance of educational program. Patient Prefer Adherence. 2011;5:555-62.
- 16 Echarri P, Pérez-Campoy MA, Coromina J, Grandi D. Papel do médico dentista no tratamento da roncopatia e do síndrome de apneia/hipoapneia obstrutiva do sono (SAHOS). J Dentistry. 2015;17:26-30.
- 17 Gharibeh T, Mehra R. Obstructive sleep apnea syndrome: natural history, diagnosis, and emerging treatment options. Nature Sci Sleep. 2010;2:233-55.
- 18 Tsuda H, Moritsuchi Y, Higuchi Y, Tsuda T. Oral health under use of continuous positive airway pressure and interest in alternative therapy in patients with obstructive sleep apnoea: a questionnaire-based survey. Gerodontology. 2015;33(3):416-20.
- 19 Flores-Mir C. Dentistry and Obstructive Sleep Apnea. J Clin Sleep Med. 2016;12(9):1213-4.
- 20 de Sousa Miranda W, Álvares de Castro Rocha V, Lara Dos Santos Marques K, Trindade Neto AI, do Prado CJ, Zanetta-Barbosa D. Three-dimensional evaluation of superior airway space after orthognathic surgery with counterclockwise rotation and advancement of the maxillomandibular complex in Class II patients. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015;120(4):453-8.
- 21 Li KK, Guilleminault C, Riley RW, Powell NB. Obstructive sleep apnea and maxillomandibular advancement: an assessment of airway changes using radiographic and nasopharyngoscopic examinations. J Oral Maxillofac Surg. 2002;60(5):526-30.
- 22 Raffaini M, Pisani C. Clinical and cone-beam computed tomography evaluation of the three-dimensional increase in pharyngeal airway space following maxillo-mandibular rotation-advancement for Class II-correction in patients without sleep apnoea (OSA). J Craniomaxillofac Surg. 2013;41(7):552-7.