title: Subjective outcomes of maxillomandibular advancement surgery for treatment of obstructive sleep apnea syndrome.
abstract: OBJECTIVE
  To evaluate subjective outcomes and use of continuous positive airway pressure (CPAP) after maxillomandibular advancement surgery for treatment of obstructive sleep apnea syndrome (OSAS).
  
  
  METHODS
  A self-administered questionnaire was completed pre- and postoperatively by 116 patients who underwent maxillomandibular advancement surgery for treatment of OSAS from February 2000 through September 2010. The questionnaire included the Epworth Sleepiness Scale (ESS) for assessment of daytime somnolence and questions regarding snoring, witnessed apneas, CPAP use, and overall satisfaction.
  
  
  RESULTS
  Preoperatively, 40% of patients were very sleepy (ESS ≥16), 32% were sleepy (ESS 10 to 16), and 28% were not sleepy (ESS ≤10). Postoperatively, only 1 patient (<1%) was very sleepy, 9% were sleepy, and 90% were not sleepy (McNemar test, P < .001). The mean ESS score for the very sleepy, sleepy, and not-sleepy groups decreased from 18.3 to 5.9, 12.9 to 4.4, and 7.3 to 4.5, respectively (P < .001). Surgery decreased snoring by 83%, witnessed apneas by 94%, and CPAP use by 96% (P < .001). The surgery was judged to be worthwhile by 89% of patients, and 95% of patients said they would recommend the treatment to other patients with OSAS.
  
  
  CONCLUSIONS
  Maxillomandibular advancement surgery for treatment of OSAS is very effective at improving excessive daytime sleepiness, snoring, and witnessed apneas. Most patients in this study were able to discontinue the use of CPAP after surgery. Overall, patients reported the treatment to be worthwhile and would recommend it to others.
authors.affiliation: Department of Oral and Maxillofacial Sciences, Dalhousie University, Halifax, Nova Scotia, Canada. reginald.goodday@dal.ca
authors.forename: Reginald
authors.initials: R
authors.lastname: Goodday
authors.forename: Susan
authors.initials: S
authors.lastname: Bourque
mesh_terms: D000328:Adult; D000368:Aged; D001049:Apnea / Q000601:surgery; D001294:Attitude to Health; D045422:Continuous Positive Airway Pressure / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019186:Mandibular Advancement / Q000379:methods*; D008437:Maxilla / Q000601:surgery*; D008875:Middle Aged; D019340:Osteotomy, Le Fort / Q000379:methods; D059229:Osteotomy, Sagittal Split Ramus / Q000379:methods; D017060:Patient Satisfaction; D011446:Prospective Studies; D057566:Self Report; D020181:Sleep Apnea, Obstructive / Q000601:surgery*; D012894:Sleep Stages / Q000502:physiology; D012913:Snoring / Q000601:surgery; D011795:Surveys and Questionnaires; D055815:Young Adult