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Review
. 2017 Jul 27;12(7):e0181146.
doi: 10.1371/journal.pone.0181146. eCollection 2017.

How does mandibular advancement with or without maxillary procedures affect pharyngeal airways? An overview of systematic reviews

Su Keng Tan  1   2 , Wai Keung Leung  3 , Alexander Tin Hong Tang  4 , Roger A Zwahlen  2
Affiliations
Review

How does mandibular advancement with or without maxillary procedures affect pharyngeal airways? An overview of systematic reviews

Su Keng Tan et al. PLoS One. .

Abstract

Background: Mandibular advancement surgery may positively affect pharyngeal airways and therefore potentially beneficial to obstructive sleep apnea (OSA).

Objective: To collect evidence from published systematic reviews that have evaluated pharyngeal airway changes related to mandibular advancement with or without maxillary procedures.

Methodology: PubMed, EMBASE, Web of Science, and Cochrane Library were searched without limiting language or timeline. Eligible systematic reviews evaluating changes in pharyngeal airway dimensions and respiratory parameters after mandibular advancement with or without maxillary surgery were identified and included.

Results: This overview has included eleven systematic reviews. Maxillomandibular advancement (MMA) increases linear, cross-sectional plane and volumetric measurements of pharyngeal airways significantly (p<0.0001), while reducing the apnea-hypopnea index (AHI) and the respiratory disturbance index (RDI) significantly (p<0.0001). Two systematic reviews included primary studies that have evaluated single-jaw mandibular advancement, but did not discuss their effect onto pharyngeal airways. Based on the included primary studies of those systematic reviews, single-jaw mandibular advancement was reported to significantly increase pharyngeal airway dimensions (p<0.05); however, conclusive long-term results were lacking.

Conclusion: MMA increases pharyngeal airway dimensions and is beneficial to patients suffering from OSA. However, more evidence is still needed to draw definite conclusion related to the effect of single-jaw mandibular advancement osteotomies on pharyngeal airways.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Study selection process.
Fig 2
Fig 2. Forest plot of total volumetric changes of pharyngeal airway after MMA.
Fig 3
Fig 3. Funnel plot for MMA studies.
See this image and copyright information in PMC

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