Indian Journal of Sleep Medicine

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VOLUME 16 , ISSUE 2 ( April-June, 2021 ) > List of Articles

Original Article

Efficacy of Distraction Osteogenesis in Management of Obstructive Sleep Apnea Secondary to Temporomandibular Joint Ankylosis

SS Agarwal, Nanda Kishore Sahoo, Sanjeev Datana, Sujit K Bhandari

Keywords : AHI, Distraction osteogenesis, Obstructive sleep apnea, TMJ ankylosis

Citation Information : Agarwal S, Sahoo NK, Datana S, Bhandari SK. Efficacy of Distraction Osteogenesis in Management of Obstructive Sleep Apnea Secondary to Temporomandibular Joint Ankylosis. Indian Sleep Med 2021; 16 (2):44-48.

DOI: 10.5005/jp-journals-10069-0071

License: CC BY-NC 4.0

Published Online: 13-07-2021

Copyright Statement:  Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim and objective: The aim and objective of this study was to evaluate the efficacy of mandibular corpus distraction osteogenesis (MCDO) in the management of obstructive sleep apnea (OSA) secondary to temporomandibular joint (TMJ) ankylosis. Materials and methods: Treatment records of 15 patients (mean age 23.3 ± 5.4 years, 7 males and 8 females) comprehensively managed for severe OSA secondary to TMJ ankylosis with combined orthodontics and MCDO were studied objectively by comparing apnea–hypopnea index (AHI) scores and airway parameters, and subjectively by Epworth sleepiness scale (ESS) survey at pretreatment (T0) and 1-year postsurgery (T1). Change in skeletal parameters at T1 was evaluated by comparison of sella-nasion-point A (SNA), sella-nasion-point B (SNB), and point A-nasion-point B (ANB) angles. Change in AHI per millimeter advancement was also calculated. Results: The mean AHI score at T0 and T1 was 41.71 ± 12.69 and 8.11 ± 3.25, respectively (80.39% reduction, p-value < 0.001). The AHI reduction per mm distraction was 2.59 ± 0.52. The success rate (postsurgical AHI less than 50% of pretreatment) was 100%, and the cure rate (AHI score <05) was 80%. The mean ESS score at T0 and T1 was 18.60 ± 2.5 and 4.67 ± 1.49, respectively (75.05% reduction, p-value < 0.001). The mean ANB at T0 and T1 was 11.6° ± 3.68° and 3.4° ± 2.29, respectively (72.89% reduction, p-value < 0.001). The mean posterior airway space (PAS) at T0 and T1 was 4.00 ± 1.46 mm and 10.00 ± 1.25 mm, respectively (182.44% increase, p-value < 0.001). Conclusions: MCDO is an effective modality for the treatment of severe OSA secondary to TMJ ankylosis. Further studies are recommended for additional evidence in this regard.


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