Pre-Surgical and Post-Surgical Assessment of the Upper Airway by Computed Tomography, In Patients with Obstructive Sleep Apnea Hypopnea Syndrome Undergoing Maxillomandibular Advancement Surgery
DOI:
https://doi.org/10.53903/01212095.3Keywords:
Palate, Sleep apnea syndromes, Mandibular advancement, TomographyAbstract
Introduction: Obstructive sleep apnea-hypopnea syndrome (OSAHS) secondary to craniofacial malformations increases morbidity and decreases quality of life of the patient. Objective: To describe the anatomical characteristics of the airway before and after surgery, in patients with OSAHS secondary to craniofacial malformations undergoing maxillo-mandibular advancement surgery. Methodology: This was a descriptive observational study in adults with OSAHS secondary to craniofacial malformations, attending the Clínica Universitaria Colombia, whom underwent maxillo-mandibular advancement surgery between December 2013 and October 2018. Pre-surgical and post-surgical measures at predefined anatomical repair points were analyzed, as well as the magnitude of the post-intervention change. Results: 57.17 % of the patients presented between 2 to 4 malformations, and the remaining 42.86 % presented 5 or more. The anatomical landmarks that presented significant changes in the post-surgical measures in subjects with 2 to 4 malformations were: The upper pharyngeal space 4.78 mm (SD 1.92), lower pharyngeal space 4.5 mm (SD 3.25), base of the epiglottis 3.21 mm (SD 2.80), the soft palate 4.92 mm (SD 2.84), the midpoint between the soft palate and the base of the epiglottis in its AP diameter 4.42 mm (SD 3.13) and transverse diameter 5.42 mm (SD 4.83). All patients with severe OSAHS presented post- surgical changes with statistically significant differences values that vary between 6.27 mm (p value 0.0011) and 4.72 mm (p value 0.0000). Conclusions: The changes in the pre- and post-surgical measures of airway anatomic landmark patients with OSAHS were characterized. These findings can be a guide for the radiologist at the time of reporting a study for this purpose, helping in the surgical planning and follow up of patients.
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