ISSN: 1305-3876
Hakkında: Özel sayılar şeklinde yayınlanır.
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Treatment Of Obstructive Sleep Apnea Syndrome: Maxillomandibular Sur-gery
Dr. Tamer ERDEMa
aKBB AD, İnönü Üniversitesi Tıp Fakültesi, MALATYA
Obstructive sleep apnea is caused by repetitive collapse and blockage of the upper airway, usually behind the tongue base and sometimes the soft palate while asleep. Comprehensive evaluation of and treatment planning for OSAS (obstructive sleep apnea syndrome) cases require a multidisciplinary team approach. Craniomaxillar abnormalies are important as underlying contributors. Recognizing that maxillary and mandibular deficiency was identified in OSA patients, the simultaneous advancement of the maxilla and the mandible has been advocated in the management of OSA. It is well known that in addition to having a decreased airway dimension patients with OSA have abnormalities in airway dynamics: a “floppy airway” due to increased collapsibility of the tongue and pharyngeal walls. It has been postulated that in addition to enlargement in the airway dimensions, the collapsibility of the airway is decreased due to increased tension of the velopharyngeal and suprahyoid musculatures after MMA (maxillomandibular advancement). Apparent improvements have been provided by MMA in cases having normal upper airway anatomy later. In literature, it has been shown that the MMA surgery is definitive therapy alone in 96-100% of patients with OSAS. Maxillomandibular distraction osteogenesis (MMDO) is one of the recent advancements in OSAS surgery. In this surgery, maxillary and mandibular bones are expanded by using distraction osteogenesis technique. Simple and less traumatic osteotomies are very advantageuos for postoperative healing. Early results are promising in cure of OSAS.Keywords: Obstructive sleep apnea, craniofacial abnormality, maxillomandibular advancement, maxillomandibular distraction osteogenesisTurkiye Klinikleri J Surg Med Sci 2007, 3(23):105-10
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