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Copyright of Orthodontie Française is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Orthodontie Française is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Summary: Despite advances in positive pressure therapy for obstructive sleep apnea, compliance continues to be a problem for many patients. Sleep apnea surgery is a viable option for patients who are intolerant of positive pressure therapy. This review will present the current state of art in sleep apnea surgery, including airway evaluation with fiberoptic nasopharyngoscopy and lateral cephalometric radiograph, formulation of a surgical plan through a selection of procedures to address specific sites of obstruction, as well as discussion of published surgical outcomes. [Copyright &y& Elsevier]

Objective To evaluate the presence of velopharyngeal insufficiency (VPI) symptoms and the associated changes of the velopharyngeal anatomy in patients who underwent maxillomandibular advancement (MMA) for persistent obstructive sleep apnea (OSA) after uvulopalatopharyngoplasty (UPPP). Methods Preoperative and postoperative cephalometric radiographs were analyzed to assess the anatomic changes of the velopharynx. In addition, a questionnaire survey was sent to the patients between 6 to 12 months after MMA. The questionnaires evaluated the presence and extent of VPI symptoms, including nasal regurgitation while eating or drinking as well as hypernasal speech. A 10-cm visual analog scale (VAS 0-10) was included to assess the impact of VPI symptoms on the patient's quality of life. In the patients who reported VPI symptoms, telephone interviews were conducted 1 year after the survey to evaluate the changes in VPI symptoms over time. Results Fifty-two of the 65 questionnaires were returned. Five patients (9.6%) reported nasal regurgitation of liquids when drinking hastily, with 2 patients reporting the occurrences as occasional and 3 patients reporting as rare. The impact of these symptoms on the patient's quality of life was minimal (VAS 0.6 ± 0.4). Regurgitation of food or hypernasal speech was not reported. The telephone interviews 1 year later revealed that the symptoms have completely resolved in all 5 patients. Comparison of the preoperative and postoperative cephalometric radiographs demonstrated the pharyngeal depth increase was 48% of the amount of maxillary advancement and the functional pharyngeal length increased 53% of the maxillary advancement. The functional depth of the pharynx after MMA was significantly greater in the patients with VPI symptoms ( P = .01). Conclusion The results of this study suggest that patients who undergo MMA for persistent OSA after UPPP have a low risk of developing VPI. If symptoms occur postoperatively, they are mild and have minimal effect on the patient's quality of life; moreover, the symptoms usually resolve over time. [ABSTRACT FROM AUTHOR]

Study Objectives: To evaluate the objective and subjective long-term outcome of maxillomandibular advancement (MMA) in Far-East Asian patients with moderate to severe obstructive sleep apnea (OSA).Methods: This is a long-term follow-up study to evaluate the treatment outcome of MMA in OSA patients by objective polysomnography (PSG) and subjective questionnaires (Pittsburgh Sleep Quality Index-PSQI, Insomnia Severity Index-ISI, Beck Anxiety Inventory-BAI, Beck Depression Inventory-BDI, Epworth Sleepiness scale-ESS, and Short Form-36 Quality of Life-SF-36). Evaluation was done before surgery and we followed these patients one and two years after surgery. We also assessed the neurocognitive function by Continuous performance test (CPT) and Wisconsin Card Sorting Test (WCST) before and after MMA.Results: A total of 82 patients with OSA (female = 19) were enrolled and 53 participants (75.7% men, age 35.66 ± 11.66 years [mean ± SD], BMI = 24.80 ± 3.29) completed the two-year follow-up. The apnea-hypopnea index (AHI) decreased from a mean of 34.78 ± 26.01 to 3.61 ± 2.79 and 7.43 ± 6.70 events/hour (p = 0.007) at the first and second year evaluation. There was significant improvement in PSG (especially respiratory profile), questionnaires (PSQI and ISI total score), and neurocognitive testing (attention and executive function) after MMA. Meanwhile, no major complication such as avascular necrosis of bonny segments, facial nerve injury, blindness or compromise of airway was found after surgery.Conclusions: MMA is a clinically effective treatment for patients with moderate-to-severe OSA as demonstrated by significant long-term decrease in AHI and improvement in neurocognitive testing. [ABSTRACT FROM AUTHOR]