title: Maxillomandibular advancement in obstructive sleep apnea syndrome patients: a restrospective study on the sagittal cephalometric variables.
abstract: OBJECTIVE
  The present retrospective study analyzes sagittal cephalometric changes in patients affected by obstructive sleep apnea syndrome submitted to maxillomandubular advancement.
  
  
  METHODS
  15 adult sleep apnea syndrome (OSAS) patients diagnosed by polysomnography (PSG) and treated with maxillomandubular advancement (MMA) were included in this study. Pre- (T1) and postsurgical (T2) PSG studies assessing the apnea/hypopnea index (AHI) and the lowest oxygen saturation (LSAT) level were compared. Lateral cephalometric radiographs at T1 and T2 measuring sagittal cephalometric variables (SNA, SNB, and ANB) were analyzed, as were the amount of maxillary and mandibular advancement (Co-A and Co-Pog), the distance from the mandibular plane to the most anterior point of the hyoid bone (Mp-H), and the posterior airway space (PAS).
  
  
  RESULTS
  Postoperatively, the overall mean AHI dropped from 58.7 ± 16 to 8.1 ± 7.8 events per hour (P < 0.001). The mean preoperative LSAT increased from 71% preoperatively to 90% after surgery (P < 0.001). All the patients in our study were successfully treated (AHI < 20 or reduced by 50%). Cephalometric analysis performed after surgery showed a statistically significant correlation between the mean SNA variation and the decrease in the AHI (P = 0.01). The overall mean SNA increase was 6°.
  
  
  CONCLUSIONS
  Our findings suggest that the improvement observed in the respiratory symptoms, namely the apnea/hypopnea episodes, is correlated with the SNA increase after surgery. This finding may help maxillofacial surgeons to establish selective criteria for the surgical approach to sleep apnea syndrome patients.
authors.affiliation: Maxillofacial Surgery Unit, Sant'Anna Hospital Como Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Ronchi
authors.affiliation: Department of Orthodontics, School of Dentistry, University of Insubria, Varese Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Cinquini
authors.affiliation: Department of Orthodontics, School of Dentistry, University of Insubria, Varese Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Ambrosoli
authors.affiliation: Department of Orthodontics, School of Dentistry, University of Insubria, Varese Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Caprioglio
keywords: cephalometry.; mandibular advancement; orthognathic surgery; sleep apnea syndromes