Maxillomandibular expansion for the treatment of sleep-disordered breathing: preliminary result.
OBJECTIVE
To assess the outcomes of maxillomandibular expansion (MME) by distraction osteogenesis (DO) for the treatment of sleep-disordered breathing (SDB).


METHODS
This was a prospective study of six consecutive patients with SDB. All of the patients have maxillary and mandibular constriction and were treated with MME. Variables examined include age, sex, body mass index (BMI), polysomnographic results (PSG), Epworth Sleepiness Scale (ESS), and the extent of the widening of the maxilla and mandible.


RESULTS
All six patients (4 males) completed MME for the treatment of SDB. The mean age was 22.2 +/- 11.4 years. The mean maxillary expansion was 10.3 +/- 3.0 mm, and the mean mandibular expansion was 9.5 +/- 2.9 mm. ESS improved from 10.2 +/- 1.9 to 5 +/- 2.9. The mean apnea/ hypopnea index (AHI) improved from 13.2 +/- 15.6 to 4.5 +/- 5.8 events per hour, and the mean lowest oxygen saturation (LSAT) improved from 88.2 +/- 2.9% to 91.3 +/- 3.3%. The mean esophageal pressure improved from -20 +/- 11.3 cm H2O to -8 +/- 3.6 cm H2O. No complications were encountered, and the follow-up period was 18.1 +/- 9.8 months.


CONCLUSIONS
: The result suggests that MME improves SDB in patients with maxillary and mandibular constriction and can be a valid treatment.
Guilleminault
Christian
C
Stanford University Sleep Disorders and Research Center, Stanford, CA 94305, USA.
Li
Kasey K
KK
D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D002648:Child; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D019248:Jaw Fixation Techniques; D008297:Male; D008334:Mandible / Q000601:surgery*; D019186:Mandibular Advancement / Q000379:methods*; D008437:Maxilla / Q000601:surgery*; D017286:Polysomnography / Q000379:methods; D011446:Prospective Studies; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000628:therapy*