To evaluate the effects of distraction osteogenesis in temporo mandibular joint ankylosis patients suffering from obstructive sleep apnea

Methods: 10 patients of Temporomanibular joint ankylosis showing retrognathia were included in study. Out of these 7 patients (5 males, 2 females) showed positive polysmnographic results for obstructive sleep apnea (OSA) (Apnea-hyponea index > 5/ h ). Distraction osteogenesis was performed (mandibular advancement) starting 7 days after surgery.

Distractor device (4 extraoral and 1 intraoral) was activated twice daily 1.0 mm/day in intraoral device and 0.8 mm in extraoral device until the anterior crossbite was achieved. Distraction device was removed 12 weeks after surgery.

Results:

  • 1.

    Epworth sleepiness scale improved from a mean of 11.71 to 2.29.

  • 2.

    Mandibular advancement was done bilaterally in 5 patients and unilateral in 2 patients, ranged from 15.0 to 27.0 mm with the mean distance being 20.48 mm.

  • 3.

    Post distraction there was improvement in clinical features of OSA like day time sleepiness and snoring.

  • 4.

    Polysmnographic analysis also showed improvement in all cases with mean AHI from 36.87 to 8.44 per hour.

  • 5.

    Lowest oxygen saturation improved from 65.52% to 72.88% and average minimum oxygen saturation improved from 93.16% to 98.10%.

  • 6.

    No. of desaturation episodes <90% reduced from 183.57 to 24.57.

  • 7.

    BMI improved from a mean of 18.04 to 21.10 kg/m 2 .

Conclusion: With the limitation of the small sample size it was seen that there was improvement in snoring, daytime sleepiness, Apnea hyponea index, oxygen saturation, no. of desaturation episodes less than 90% oxygen in all patients. Hence it is beneficial to do DO in TMJ ankylosis patients showing OSA.

Conflict of interest: None declared.

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Jan 27, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on To evaluate the effects of distraction osteogenesis in temporo mandibular joint ankylosis patients suffering from obstructive sleep apnea
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