EFFECTIVENESS OF LE FORT III OSTEOTOMY ON OBSTRUCTIVE SLEEP APNEA SYNDROME IN CRANIOFACIAL SYNOSTOSIS
Authors:
Mirabella S.1,2, Mazzoleni F.2, Meazzini MC.2,4, Moretti M.1,2, Canzi G.3, Sozzi D.2, Novelli G.2
Affiliation:
1 Maxillo-Facial Surgery Specialization School, University of Milan
2 Maxillo-Facial Division, IRCCS San Gerardo Dei Tintori, Monza – University of Milano Bicocca
3 Maxillo-Facial Division, Grande Ospedale Metropolitano Niguarda, Milan
4 Regional Center for CLP San Paolo Hospital, Milano
Doi: 10.54936/haoms242p94
ABSTRACT:
Aim: Craniofacial synostosis are syndromes characterized by hypoplasia and retrusion of midface, usually associated with skull base deformity, laxity and redundancy of pharyngeal soft tissues and adeno-tonsillar hypertrophy. These morphological alteration leads to different degrees of upper airway obstruction and obstructive sleep apnea syndrome (OSAS). The scientific literature is not unanimous in evaluating results regarding the effectiveness of midfacial advancement for the treatment of OSAS in patients affected by craniofacial synostosis. This study aims to evaluate the correlation between midface skeletal movements and anatomical changes in airways, as well as changes in the polysomnographic parameters, in patients affected by craniofacial synostosis.
Material and methods: 29 patients affected by craniofacial synostosis and OSAS who underwent a Le Fort III osteotomy with classic technique or using a rigid external distractor (RED) were included. For each patient, lateral standardized cephalometric X-Ray or CT scan and polysomnography were collected before and after surgery. Changes between pre-and post-operative cephalometric and polysomnographic parameters were then evaluated.
Results: Skeletal changes obtained with Le Fort III osteotomy were all highly statistically significant as well as the improvement in polysomnographic parameters. However, the polysomnographic changes were not linear with the bony advancement.
Conclusions: This study confirms that Le Fort III osteotomy has a positive effect on OSAS due to an effective advancement of midface. However, we have to consider that an important role in the genesis of OSAS is played also by soft-tissue tone, adeno-tonsillar hypertrophy and oropharyngeal stenosis.
KEY WORDS:
Authors:
Mirabella S.1,2, Mazzoleni F.2, Meazzini MC.2,4, Moretti M.1,2, Canzi G.3, Sozzi D.2, Novelli G.2
Affiliation:
1 Maxillo-Facial Surgery Specialization School, University of Milan
2 Maxillo-Facial Division, IRCCS San Gerardo Dei Tintori, Monza – University of Milano Bicocca
3 Maxillo-Facial Division, Grande Ospedale Metropolitano Niguarda, Milan
4 Regional Center for CLP San Paolo Hospital, Milano
Doi: 10.54936/haoms242p94
ABSTRACT:
Aim: Craniofacial synostosis are syndromes characterized by hypoplasia and retrusion of midface, usually associated with skull base deformity, laxity and redundancy of pharyngeal soft tissues and adeno-tonsillar hypertrophy. These morphological alteration leads to different degrees of upper airway obstruction and obstructive sleep apnea syndrome (OSAS). The scientific literature is not unanimous in evaluating results regarding the effectiveness of midfacial advancement for the treatment of OSAS in patients affected by craniofacial synostosis. This study aims to evaluate the correlation between midface skeletal movements and anatomical changes in airways, as well as changes in the polysomnographic parameters, in patients affected by craniofacial synostosis.
Material and methods: 29 patients affected by craniofacial synostosis and OSAS who underwent a Le Fort III osteotomy with classic technique or using a rigid external distractor (RED) were included. For each patient, lateral standardized cephalometric X-Ray or CT scan and polysomnography were collected before and after surgery. Changes between pre-and post-operative cephalometric and polysomnographic parameters were then evaluated.
Results: Skeletal changes obtained with Le Fort III osteotomy were all highly statistically significant as well as the improvement in polysomnographic parameters. However, the polysomnographic changes were not linear with the bony advancement.
Conclusions: This study confirms that Le Fort III osteotomy has a positive effect on OSAS due to an effective advancement of midface. However, we have to consider that an important role in the genesis of OSAS is played also by soft-tissue tone, adeno-tonsillar hypertrophy and oropharyngeal stenosis.
KEY WORDS: