Distraction osteogenesis for management of obstructive sleep apnoea in temporomandibular joint ankylosis patients before the release of joint.

Abstract

AIM:

To evaluate the effects of distraction osteogenesis in management of obstructive sleep apnoea patients secondary to temporomandibular joints ankylosis.

METHODS:

Fifteen patients were included in study. Preoperatively the patients were worked up for polysomnography and CT scans. Only those patients with Apnoea-hypopnoea index >15 events/h denoting moderate to severe obstructive sleep apnoea were included in the study. Distraction osteogenesis was followed with 5 days latency period in adult patients and 0 days for children. Rate of distraction was 1 mm/day for adults and 2 mm/day for children till the mandibular incisors were in reverse overjet. After 3 months post distraction assessment was done using polysomnography and CT scan. TMJ ankylosis was released by doing gap arthroplasty after distraction osteogenesis.

RESULTS:

Post distraction improvement was seen in clinical features of OSA like daytime sleepiness and snoring. Epworth sleepiness scale improved from a mean of 10.25 to 2.25. Polysomnographic analysis also showed improvement in all cases with apnoea-hypopnoea index from 57.03 to 6.67 per hour. Lowest oxygen saturation improved from 64.47% to 81.20% and average minimum oxygen saturation improved from 92.17% to 98.19%. Body mass index improved from a mean of 18.26 to 21.39 kg/m2.

CONCLUSION:

Distraction osteogenesis is a stable and beneficial treatment option for temporomandibular joint ankylosis patients with obstructive sleep apnoea.

• Authors: Rahul Yadav, Ongkila Bhutia, Garima Shukla, Ajoy Roychoudhury
• Journal: Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery (J Craniomaxillofac Surg) Vol. 42 Issue 5 Pg. 588-94 (Jul 2014) ISSN: 1878-4119 [Electronic] Scotland
• PMID: 24529347 (Publication Type: Journal Article)
• Copyright: Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Chemical References

• Oxygen

Topics

• Adolescent
• Adult
• Ankylosis (complications, surgery)
• Arthroplasty (methods)
• Body Mass Index
• Cephalometry (methods)
• Child
• Child, Preschool
• Female
• Follow-Up Studies
• Humans
• Male
• Mandible (surgery)
• Mandibular Advancement (methods)
• Middle Aged
• Osteogenesis, Distraction (methods)
• Oxygen (blood)
• Polysomnography (methods)
• Prospective Studies
• Retrognathia (etiology, surgery)
• Sleep Apnea, Obstructive (etiology, surgery)
• Sleep Stages (physiology)
• Snoring (therapy)
• Surgical Wound Infection (etiology)
• Temporomandibular Joint Disorders (complications, surgery)
• Tomography, X-Ray Computed (methods)
• Young Adult