title: Distraction osteogenesis for management of obstructive sleep apnoea in temporomandibular joint ankylosis patients before the release of joint.
abstract: OBJECTIVE
  To evaluate the effects of distraction osteogenesis in management of obstructive sleep apnoea patients secondary to temporomandibular joints ankylosis.
  
  
  METHODS
  Fifteen patients were included in study. Preoperatively the patients were worked up for polysomnography and CT scans. Only those patients with Apnoea-hypopnoea index >15 events/h denoting moderate to severe obstructive sleep apnoea were included in the study. Distraction osteogenesis was followed with 5 days latency period in adult patients and 0 days for children. Rate of distraction was 1 mm/day for adults and 2 mm/day for children till the mandibular incisors were in reverse overjet. After 3 months post distraction assessment was done using polysomnography and CT scan. TMJ ankylosis was released by doing gap arthroplasty after distraction osteogenesis.
  
  
  RESULTS
  Post distraction improvement was seen in clinical features of OSA like daytime sleepiness and snoring. Epworth sleepiness scale improved from a mean of 10.25 to 2.25. Polysomnographic analysis also showed improvement in all cases with apnoea-hypopnoea index from 57.03 to 6.67 per hour. Lowest oxygen saturation improved from 64.47% to 81.20% and average minimum oxygen saturation improved from 92.17% to 98.19%. Body mass index improved from a mean of 18.26 to 21.39 kg/m2.
  
  
  CONCLUSIONS
  Distraction osteogenesis is a stable and beneficial treatment option for temporomandibular joint ankylosis patients with obstructive sleep apnoea.
authors: Department of Oral & Maxillofacial Surgery (Head: Dr. Ajoy Roychoudhury), All India Institute of Medical Sciences, New Delhi 110029, India.
authors: Rahul
authors: R
authors: Yadav
authors: Department of Oral & Maxillofacial Surgery (Head: Dr. Ajoy Roychoudhury), All India Institute of Medical Sciences, New Delhi 110029, India. Electronic address: dr_ongkila@rediffmail.com.
authors: Ongkila
authors: O
authors: Bhutia
authors: Department of Neurology, All India Institute of Medical Sciences, New Delhi 110029, India.
authors: Garima
authors: G
authors: Shukla
authors: Department of Oral & Maxillofacial Surgery (Head: Dr. Ajoy Roychoudhury), All India Institute of Medical Sciences, New Delhi 110029, India.
authors: Ajoy
authors: A
authors: Roychoudhury
mesh_terms: D000293:Adolescent; D000328:Adult; D000844:Ankylosis / Q000150:complications* / Q000601:surgery; D001178:Arthroplasty / Q000379:methods; D015992:Body Mass Index; D002508:Cephalometry / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery*; D019186:Mandibular Advancement / Q000379:methods; D008875:Middle Aged; D019857:Osteogenesis, Distraction / Q000379:methods*; D010100:Oxygen / Q000097:blood; D017286:Polysomnography / Q000379:methods; D011446:Prospective Studies; D063173:Retrognathia / Q000209:etiology / Q000601:surgery; D020181:Sleep Apnea, Obstructive / Q000209:etiology / Q000601:surgery*; D012894:Sleep Stages / Q000502:physiology; D012913:Snoring / Q000628:therapy; D013530:Surgical Wound Infection / Q000209:etiology; D013705:Temporomandibular Joint Disorders / Q000150:complications* / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods; D055815:Young Adult
chemical_list: D010100:Oxygen
keywords: Blood oxygen saturation; Obstructive sleep apnoea; Retrognathia; Temporomandibular joint ankylosis