A Comprehensive Strategy for Improving Nasal Outcomes after Large Maxillomandibular Advancement for Obstructive Sleep Apnea. Facial plastic surgery & aesthetic medicine Abdelwahab, M., Poomkonsarn, S., Ren, X., Awad, M., Capasso, R., Riley, R., Most, S., Liu, S. Y. 2021

Abstract

Background: Rate of corrective nasal surgery after maxillomandibular advancement (MMA) for obstructive sleep apnea (OSA) has been reported to be 18.7% for functional and aesthetic indications. Objective: Describe a comprehensive strategy to optimize nasal outcomes with MMA for OSA. Methods: A retrospective review of patients undergoing MMA for OSA in a tertiary referral center was performed, with a comprehensive perioperative intervention to optimize nasal outcomes from January 2014 to February 2018. Outcomes included the Apnea-Hypopnea Index (AHI), oxygen saturation (SpO2) nadir, corrective nasal surgery needed after MMA, and Nasal Obstruction Symptom Evaluation (NOSE) scores. Results: AHI after MMA showed significant reduction (-34.65, p<0.001), SpO2 nadir increased (+6.08, p<0.001), and NOSE scores decreased (-5.96, p<0.001). Corrective nasal surgery needed after MMA was reported in 6.5% (8 of 122) subjects at a mean of 8.5 months, ranging from 1 to 24.7 months. Six subjects underwent either septoplasty and/or valve stenosis repair, and two subjects underwent functional and aesthetic rhinoplasty. Conclusion: A perioperative strategy was applied since 2014 that showed effectiveness in reducing post-MMA corrective nasal surgery to 6.5%.

View details for DOI 10.1089/fpsam.2020.0569

View details for PubMedID 34287054