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Maxillary expansion and maxillomandibular expansion for adult OSA: A systematic review and meta-analysis. | LitMetric

Maxillary expansion and maxillomandibular expansion for adult OSA: A systematic review and meta-analysis.

J Craniomaxillofac Surg

Otolaryngology - Head and Neck Surgery, Division of Sleep Surgery and Medicine, Tripler Army Medical Center, 1 Jarrett White Road, Honolulu, HI 96859, USA; Department of Psychiatry and Behavioral Sciences, Sleep Medicine Division, Stanford Hospital and Clinics, Stanford, CA 95304, USA. Electronic address:

Published: May 2016

AI Article Synopsis

  • The study reviewed international literature on maxillary and maxillomandibular expansion as treatments for obstructive sleep apnea (OSA) in adults.
  • Eight studies involving 39 patients showed significant improvements in the apnea-hypopnea index (AHI) and lowest oxygen saturation (LSAT) after maxillary expansion.
  • While results were promising, especially for maxillomandibular expansion, the limited number of studies suggests further research is needed to confirm these findings.

Article Abstract

Objective: This study sought to systematically review the international literature for articles evaluating maxillary expansion and maxillomandibular expansion as treatments for obstructive sleep apnea (OSA) in adults and to perform a meta-analysis.

Data Sources: Nine databases (including MEDLINE/PubMed).

Review Methods: Searches were performed through January 8, 2016. The PRISMA statement was followed.

Results: Eight adult studies (39 patients) reported polysomnography and/or sleepiness outcomes. Six studies reported outcomes for maxillary expansion (36 patients), and the apnea-hypopnea index (AHI) decreased from a mean (M) ± standard deviation (SD) of 24.3 ± 27.5 [95% CI 15.3, 33.3] to 9.9 ± 13.7 [95% CI 5.4, 14.4] events/hr (relative reduction: 59.3%). Maxillary expansion improved lowest oxygen saturation (LSAT) from a M ± SD of 84.3 ± 8.1% [95% CI 81.7, 87.0] to 86.9 ± 5.6% [95% CI 85.1, 88.7]. Maxillomandibular expansion was reported in two studies (3 patients) and AHI decreased from a M ± SD of 47.53 ± 29.81 [95% CI -26.5 to 121.5] to 10.7 ± 3.2 [95% CI 2.8, 18.6] events/hr (relative reduction: 77.5%). Maxillomandibular expansion improved LSAT from a M ± SD of 76.7 ± 14.5% [95% CI 40.7, 112.7] to 89.3 ± 3.1 [95% CI 81.6, 97].

Conclusion: The current literature demonstrates that maxillary expansion can improve and maxillomandibular expansion can possibly improve AHI and LSAT in adults; however, given the paucity of studies, these remain open for additional research efforts.

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Source
http://dx.doi.org/10.1016/j.jcms.2016.02.001DOI Listing

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