title: Bone-anchored maxillary expansion and bilateral interoral mandibular distraction osteogenesis in adult with severe obstructive sleep apnea syndrome.
abstract: Severe obstructive sleep apnea syndrome (OSAS) threatens patients' lives. To solve ventilation problem, snoring, and avoid another orthognathic surgery for mandibular advancement, bone-anchored rapid maxillary expansion and bilateral interoral mandibular distraction osteogenesis were tried on a 20-year-old Chinese male patient with severe skeletal class II malocclusion and OSAS.The patient had polysomnography (apnea-hypopnea index 54.2), body mass index measurement (19.7 kg/m), and cephalometry before the treatment. Bone-anchored rapid maxillary expansion was performed for the correction of maxillary transverse and minor sagittal deficiency and the improvement of nasal airflow by decreasing nasal resistance. Bilateral interoral mandibular distraction osteogenesis was operated to lengthen the small, retruded mandible by 15 mm. Orthodontic treatment after the maxillary expansion and mandibular distraction osteogenesis can help obtain stable occlusion.The Epworth Sleepiness Scale, a questionnaire for temporomandibular joint, cephalometric analysis, polysomnography, acoustic rhinometry, and multislice spiral computed tomography were performed to evaluate changes from the treatment. All the results showed that the patient had a significantly alleviated OSAS. In addition, an acceptable occlusion was also obtained.
authors.affiliation: Center of Craniofacial Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Nie
authors.forename: Min
authors.initials: M
authors.lastname: Zhu
authors.forename: Xiao-Feng
authors.initials: XF
authors.lastname: Lu
authors.forename: Bing
authors.initials: B
authors.lastname: Fang
mesh_terms: D002508:Cephalometry / Q000379:methods; D006801:Humans; D008297:Male; D008312:Malocclusion, Angle Class II / Q000601:surgery; D008334:Mandible / Q000601:surgery*; D019186:Mandibular Advancement / Q000379:methods; D008437:Maxilla / Q000601:surgery; D052280:Orthodontic Anchorage Procedures / Q000295:instrumentation*; D019857:Osteogenesis, Distraction / Q000379:methods*; D010155:Palatal Expansion Technique / Q000295:instrumentation*; D010347:Patient Care Planning; D017286:Polysomnography / Q000379:methods; D012123:Pulmonary Ventilation / Q000502:physiology; D023842:Rhinometry, Acoustic / Q000379:methods; D020181:Sleep Apnea, Obstructive / Q000601:surgery*; D012894:Sleep Stages / Q000502:physiology; D012913:Snoring / Q000601:surgery; D013704:Temporomandibular Joint / Q000502:physiology; D036542:Tomography, Spiral Computed / Q000379:methods; D055815:Young Adult