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Review
. 2022 Nov 16;11(22):6782.
doi: 10.3390/jcm11226782.

Maxillomandibular Advancement and Upper Airway Stimulation for Treatment of Obstructive Sleep Apnea: A Systematic Review

Ning Zhou  1   2   3 , Jean-Pierre T F Ho  1   2   4 , René Spijker  5   6 , Ghizlane Aarab  3 , Nico de Vries  3   7   8 , Madeline J L Ravesloot  7 , Jan de Lange  1   2
Affiliations
Review

Maxillomandibular Advancement and Upper Airway Stimulation for Treatment of Obstructive Sleep Apnea: A Systematic Review

Ning Zhou et al. J Clin Med. .

Abstract

This systematic review aimed to comparatively evaluate the efficacy and safety of maxillomandibular advancement (MMA) and upper airway stimulation (UAS) in obstructive sleep apnea (OSA) treatment. A MEDLINE and Embase database search of articles on MMA and/or UAS for OSA was conducted. Twenty-one MMA studies and nine UAS studies were included. All the MMA studies demonstrated a reduction in apnea hypopnea index (AHI) postoperatively, and success rates ranged from 41.1% to 100%. Ten MMA studies reported pre- and postoperative Epworth sleepiness scale (ESS), and all but one study demonstrated a reduction in ESS. In the UAS studies, all but one demonstrated a reduction in AHI, and success rates ranged from 26.7% to 77.8%. In the eight UAS studies reporting pre- and postoperative ESS, an ESS reduction was demonstrated. No studies reported any deaths related to MMA or UAS. The most common postoperative complications after MMA and UAS were facial paresthesia in the mandibular area and discomfort due to electrical stimulation, respectively. This systematic review suggests that both MMA and UAS are effective and generally safe therapies for OSA. However, due to the limitations of the included studies, there is no evidence yet to directly compare these two procedures in OSA treatment.

Keywords: hypoglossal nerve; maxillomandibular surgery; obstructive sleep apnea; systematic review; therapy.

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Conflict of interest statement

Author G.A. receives research grants from Sunstar Suisse SA and Vivisol-ResMed and is an unpaid member of the academic advisory board for Oral Function (Sunstar Suisse SA); author N.d.V is member of the Medical Advisory Board of NightBalance and consultant to Philips Healthcare, Inspire, and Nyxoah; the other authors declare they have no conflicts of interest. The funders had no role in the design of the study; in the collection, analysis, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
PRISMA flow diagram of the study selection process.
See this image and copyright information in PMC

References

    1. Jordan A.S., McSharry D.G., Malhotra A. Adult obstructive sleep apnoea. Lancet. 2014;383:736–747. doi: 10.1016/S0140-6736(13)60734-5. - DOI - PMC - PubMed
    1. Senaratna C.V., Perret J.L., Lodge C.J., Lowe A.J., Campbell B.E., Matheson M.C., Hamilton G.S., Dharmage S.C. Prevalence of obstructive sleep apnea in the general population: A systematic review. Sleep Med. Rev. 2017;34:70–81. doi: 10.1016/j.smrv.2016.07.002. - DOI - PubMed
    1. Bagai K. Obstructive sleep apnea, stroke, and cardiovascular diseases. Neurologist. 2010;16:329–339. doi: 10.1097/NRL.0b013e3181f097cb. - DOI - PubMed
    1. Knauert M., Naik S., Gillespie M.B., Kryger M. Clinical consequences and economic costs of untreated obstructive sleep apnea syndrome. World J. Otorhinolaryngol. Head Neck Surg. 2015;1:17–27. doi: 10.1016/j.wjorl.2015.08.001. - DOI - PMC - PubMed
    1. Gottlieb D.J., Punjabi N.M. Diagnosis and Management of Obstructive Sleep Apnea: A Review. JAMA. 2020;323:1389–1400. doi: 10.1001/jama.2020.3514. - DOI - PubMed

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