Surgical treatment for the obstructive sleep apnea : A review

수면 무호흡증 환자의 수술적 치료에 대한 고찰

  • Kim, Weon Jae (Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University) ;
  • Kwon, Yong Dae (Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University)
  • 김원재 (경희대학교 치과대학병원 구강악안면외과) ;
  • 권용대 (경희대학교 치과대학병원 구강악안면외과)
  • Published : 2019.04.30

Abstract

Obstructive sleep apnea syndrome (OSAS) is characterized by obstructive events of the upper airway (UAW) during sleep, which can be associated with clinical signs and symptoms such as snoring, excessive daytime sleepiness, impaired memory, and fatigue. It is associated with many problems like psychosocial problems, physiologic alterations in the cardiovascular and respiratory systems as a result of hypoxia and repeated awakenings during sleep. Conservative treatments such as weight loss, sleep positioning, improvement of sleep hygiene, CPAP and MAD can be performed for the obstructive sleep apnea. However, their effect for the OSA is limited and differs by patient's individual properties. Accordingly, surgical reconstructions of the upper airway must be carried out for the treatment of OSA.

Keywords

References

  1. Gottlieb DJ, Whitney CW, Bonekat WH, Iber C, James GD, Lebowitz M, et al. Relation of sleepiness to respiratory disturbance index: the Sleep Heart Health Study. Am J Respir Crit Care Med 1999;159(2):502-507. https://doi.org/10.1164/ajrccm.159.2.9804051
  2. Boyd SB, Walters AS, Waite P, Harding SM, Song Y. Long-term effectiveness and safety of maxillomandibular advancement for treatment of obstructive sleep apnea. J Clin Sleep Med 2015;11(7):699-708. https://doi.org/10.5664/jcsm.4838
  3. Johns FR, Strollo PJ, Buckley M, Constantino J. The influence of craniofacial structure on obstructive sleep apnea in young adults. J Oral Maxillofac Surg 1998;56(5):596-602. https://doi.org/10.1016/S0278-2391(98)90459-1
  4. Song SA, Chang ET, Certal V, Do MD, Zaghi S, Liu SY, Capasso R, Camacho M. Genial Tubercle Advancement and Genioplasty for Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis. Laryngoscope 2017;127(4):984-992. https://doi.org/10.1002/lary.26218
  5. Holty JEC, Guilleminault C. Maxillomandibular advancement for the treatment of obstructive sleep apnea: A systematic review and meta-analysis. Sleep Med Reviews 2010;14(5):287-297 https://doi.org/10.1016/j.smrv.2009.11.003
  6. Brietzke SE, Gallagher D. The effectiveness of tonsillectomy and adenoidectomy in the treatment of pediatric obstructive sleep apnea/hypopnea syndrome: a meta-analysis. Otolaryngol Head Neck Surg 2006;134(6):979-84. https://doi.org/10.1016/j.otohns.2006.02.033
  7. Arrica M, Crawford MW. Complete upper airway obstruction after induction of anesthesia in a child with undiagnosed lingual tonsil hypertrophy. Paediatr Anaesth 2006;16:584-7. https://doi.org/10.1111/j.1460-9592.2005.01802.x
  8. Wang YC, Liao YF, Li HY, Chen YR. Genial tubercle position and dimensions by cone-beam computerized tomography in a Taiwanese sample. Oral and maxillofacial radiology 2012;113(6):e46-e50
  9. Maturo SC, Mair EA. Coblation lingual tonsillectomy. Otolaryngol Head Neck Surg 2006;135:487- 8. https://doi.org/10.1016/j.otohns.2006.04.015
  10. Yin SK, Yi HL, Lu WY, Guan J, Wu HM, Cao ZY. Genioglossus advancement and hyoid suspension plus uvulopalatopharyngoplasty for severe OSAHS. Otolaryngol Head Neck Surg 2007;136(4):626-631 https://doi.org/10.1016/j.otohns.2006.01.028
  11. Hormann K, Verse T. The surgical treatment of sleep related upper airway obstruction. Dtsch Arztebl Int 2011;108(13):216-221.
  12. Darrow DH. Surgery for pediatric sleep apnea. Otolaryngol Clin North Am 2007;40:855-75.. https://doi.org/10.1016/j.otc.2007.04.008
  13. Deutsch ES. Tonsillectomy and adenoidectomy; changing indications. Pediatr Clin North Am 1996;43:1319-1338. https://doi.org/10.1016/S0031-3955(05)70521-6
  14. Guilleminault C, Hill MW, Simmons FB, Dement WC. Obstructive sleep apnea: electromyographic and fiberoptic studies. Exp Neurol 1978;62(1):48-67. https://doi.org/10.1016/0014-4886(78)90040-7
  15. Schwartz AR, Bennett ML, Smith PL, De Backer W, Hedner J, Boudewyns A, et al. Therapeutic electrical stimulation of the hypoglossal nerve in obstructive sleep apnea. Arch Otolaryngol Head Neck Surg 2001;127(10):1216-1223 https://doi.org/10.1001/archotol.127.10.1216
  16. Heiser C, Hofauer B, Lozier L, Woodson BT, Stark T. Nerve monitoring-guided selective hypoglossal nerve stimulation in obstructive sleep apnea patients. Laryngoscope 2016;126(12):2852-2858. https://doi.org/10.1002/lary.26026
  17. Goding GS, Jr., Tesfayesus W, Kezirian EJ. Hypoglossal nerve stimulation and airway changes under fluoroscopy. Otolaryngol Head Neck Surg 2012;146(6):1017-1022. https://doi.org/10.1177/0194599812436472
  18. Waite PD, Shettar SM. Maxillomandibular advancement surgery: a cure for obstructive sleep apnea syndrome. Oral Maxillofac Surg Clin North Am 1995;7:327-336 https://doi.org/10.1016/S1042-3699(20)30829-3
  19. Butterfield KJ, Marks PLG, McLean L, et al. Linear and volumetric airway changes after maxillomandibular advancement for obstructive sleep apnea. J Oral Maxillofac Surg 2015;73:1133-1142 https://doi.org/10.1016/j.joms.2014.11.020
  20. Hong SO, Chen YF, Jung J, Kwon YD, Liu SYC. Hypoglossal nerve stimulation for treatment of obstructive sleep apnea (OSA): a primer for oral and maxillofacial surgeons. Maxillofac plastic and recon surg 2017;39(1): 27 https://doi.org/10.1186/s40902-017-0126-0
  21. Lee WJ, Hwang DH, Liu SYC, Kim SJ. Subtypes of Maxillomandibular Advancement Surgery for Patients With Obstructive Sleep Apnea. J Craniofac Surg 2016;27(8):1965-1970 https://doi.org/10.1097/SCS.0000000000003027
  22. Lin AC, Koltai PJ. Persistent pediatric obstructive sleep apnea and lingual tonsillectomy, Otolaryngol Head Neck Surg 2009;141, 81-85 https://doi.org/10.1016/j.otohns.2009.03.011
  23. Darrow DH, Siemens C. Indications for Tonsillectomy and Adenoidectomy, Laryngoscope 2002;112(100):6-10 https://doi.org/10.1002/lary.5541121404
  24. Mickelson SA. Laser-Assisted Uvulopalatoplasty for Obstructive Sleep Apnea, Laryngoscope 1996;106(1):10-13 https://doi.org/10.1097/00005537-199601000-00003
  25. Brevi BC, Toma L, Sesenna E. Counterclockwise rotation of the occlusal plane in the treatment of obstructive sleep apnea syndrome. J Oral Maxillofac Surg 2011;69:917-923 https://doi.org/10.1016/j.joms.2010.06.189
  26. Goncalves JR, Gomes LCR, Vianna AP, et al. Airway space changes after maxillomandibular counterclockwise rotation and mandibular advancement with TMJ Concepts total joint prostheses: threedimensional assessment. Int J Oral Maxillofac Surg 2013;42:1014 https://doi.org/10.1016/j.ijom.2013.04.009
  27. Li KK. Maxillomandibular advancement for obstructive sleep apnea. J Oral Maxillofac Surg 2011;69:687-694 https://doi.org/10.1016/j.joms.2010.09.014
  28. Liao YF, Chiu YT, Lin CH, et al. Modified maxillomandibular advancement for obstructive sleep apnoea: towards a better outcome for Asians. Int J Oral Maxillofac Surg 2015;44:189-194 https://doi.org/10.1016/j.ijom.2014.09.013
  29. Caples SM, Gami AS, Somers VK. Obstructive Sleep Apnea. Ann Intern Med. 2005;142(3):187-197. https://doi.org/10.7326/0003-4819-142-3-200502010-00010
  30. Li KK, Riley RW, Powell NB, Troell RJ. Obstructive sleep apnea surgery: genioglossus advancement revisited. J Oral Maxillofac Surg 2001;59:1181-4. https://doi.org/10.1053/joms.2001.27111
  31. Eastwood PR, Barnes M, Walsh JH. Treating Obstructive Sleep Apnea with Hypoglossal Nerve Stimulation. Sleep 2011;34(11):1479-1486 https://doi.org/10.5665/sleep.1380
  32. Prinsell JR. Maxillomandibular advancement surgery for obstructive sleep apnea syndrome. J Am Dental association 2002;133(11):1489-1497 https://doi.org/10.14219/jada.archive.2002.0079
  33. Riley RW, Powell NB, Li KK, Troell RJ, Guilleminault C. Surgery and obstructive sleep apnea: long-term clinical outcomes. Otolaryngol Head Neck Surg 2000;122:415-421. https://doi.org/10.1067/mhn.2000.102117
  34. Won CHJ, Li KK, Guilleminault C. Surgical treatment of obstructive sleep apnea upper airway and maxillomandibular surgery. Proc Am Thorac Soc. J. 2008;5(2):193-199 https://doi.org/10.1513/pats.200708-121MG
  35. Leiberman A, Stiller-Timor L, Tarasiuk A, Tal A. The effect of adenotonsillectomy on children suffering from obstructive sleep apnea syndrome (OSAS): the Negev perspective. Int J Pediatr Otorhinolaryngol 2006;70:1675-1682. https://doi.org/10.1016/j.ijporl.2006.06.002
  36. Li KK, Riley RW, Powell NB, Guilleminault C. Patient's perception of the facial appearance after maxillomandibular advancement for obstructive sleep apnea syndrome. J Oral Maxillofac Surg 2001;59:377-80. https://doi.org/10.1053/joms.2001.21870