Academic Journal
Maxillomandibular Advancement and Tracheostomy for Morbidly Obese Obstructive Sleep Apnea ; A Systematic Review and Meta‐analysis
| العنوان: | Maxillomandibular Advancement and Tracheostomy for Morbidly Obese Obstructive Sleep Apnea ; A Systematic Review and Meta‐analysis |
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| المؤلفون: | Camacho, Macario, Teixeira, Jeffrey, Abdullatif, Jose, Acevedo, Jason L., Certal, Victor, Capasso, Robson, Powell, Nelson B. |
| المصدر: | Otolaryngology–Head and Neck Surgery ; volume 152, issue 4, page 619-630 ; ISSN 0194-5998 1097-6817 |
| بيانات النشر: | Wiley |
| سنة النشر: | 2015 |
| المجموعة: | Wiley Online Library (Open Access Articles via Crossref) |
| الوصف: | Objective The objective of this study is to systematically review polysomnography data and sleepiness in morbidly obese (body mass index [BMI] ≥40 kg/m 2 ) patients with obstructive sleep apnea (OSA) treated with either a maxillomandibular advancement (MMA) or a tracheostomy and to evaluate the outcomes. Data Sources MEDLINE, Scopus, Web of Science, and the Cochrane Library. Review Methods A search was performed from inception through April 8, 2014, in each database. Results Six maxillomandibular advancement studies (34 patients, age 42.42 ± 9.13 years, mean BMI 44.88 ± 4.28 kg/m 2 ) and 6 tracheostomy studies (14 patients, age 52.21 ± 10.40 years, mean BMI 47.93 ± 7.55 kg/m 2 ) reported individual patient data. The pre‐ and post‐MMA means ± SDs for apnea‐hypopnea indices were 86.18 ± 33.25/h and 9.16 ± 7.89/h ( P <. 00001), and lowest oxygen saturations were 66.58% ± 16.41% and 87.03% ± 5.90% ( P <. 00001), respectively. Sleepiness following MMA decreased in all 5 patients for whom it was reported. The pre‐ and posttracheostomy mean ± SD values for apnea indices were 64.43 ± 41.35/h and 1.73 ± 2.68/h ( P =. 0086), oxygen desaturation indices were 69.20 ± 26.10/h and 41.38 ± 36.28/h ( P =. 22), and lowest oxygen saturations were 55.17% ± 16.46% and 79.83% ± 4.36% ( P =. 011), respectively. Two studies reported outcomes for Epworth Sleepiness Scale for 5 patients, with mean ± SD values of 18.80 ± 4.02 before tracheostomy and 2.80 ± 2.77 after tracheostomy ( P =. 0034). Conclusion Data for MMA and tracheostomy as treatment for morbidly obese, adult OSA patients are significantly limited. We caution surgeons about drawing definitive conclusions from these limited studies; higher level studies are needed. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| DOI: | 10.1177/0194599814568284 |
| الاتاحة: | http://dx.doi.org/10.1177/0194599814568284 https://onlinelibrary.wiley.com/doi/pdf/10.1177/0194599814568284 https://onlinelibrary.wiley.com/doi/full-xml/10.1177/0194599814568284 |
| Rights: | http://onlinelibrary.wiley.com/termsAndConditions#vor |
| رقم الانضمام: | edsbas.39434903 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1177/0194599814568284 |
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