Evaluation of severe obstructive sleep apnea/hypopnea syndrome after maxillomandibular advancement surgery

Objective: To evaluate the effectiveness of the maxilomandibular advancement surgery in patients suffering from obstructive sleep apnea/hypopnea syndrome by analysing it objectively and subjectively. Methods: Ten patients suffering from apnea/hypopnea syndrome index above 30 events per sleep hour, diagnosed by polysomnography were examined. The patients underwent physical, polysomnographic and cephalometric tests and were subjectively evaluated according to the Epworth Sleepness Scale. The data obtained was compared to the results of the same group 6 months after the surgery. Results: After the maxilomandibular advancement surgery, as related to an objective evaluation by polysomnography, the results were the following: 20% of the patents had a normal apnea/hypopnea index, 30% of the patients had a moderate apnea/hypopnea index and 40% of the patients kept a severe apnea/hypopnea index, 60% of the patients had a 50% decrease in the apnea/hypopnea index and only 10% of the patients had an increase in the apnea/hypopnea index. The average of the lowest oxyhemoglobin saturation in the preoperative was 63.4%, and a significant improvement was obtained after the maxilomandibular advancement procedure when an average of 80.8%, and 70% of the patients showed a lowest oxyhemoglobin saturation above 83%. As for the subjective evaluation using the Epworth Sleepness Scale, there was an improvement in 100% of the patients. Conclusions: The objective evaluation of the maxilomandibular advancement surgery showed that it was effective in 60% of the patients suffering from severe apnea/hypopnea index, while the subjective evaluation showed that it was effective in 100% of the patients.