(18) Maxillomandibular Advancement Efficacy Differs Across Ethnicities Based on Polysomnography, Drug-Induced Sleep Endoscopy, and Self-Reported Outcomes

Thursday, September 15, 2022

1:30 PM – 3:00 PM CDT

Presenting Author(s)

MA

Mohamed Abdelwahab, MD, MS

Clinical Instructor
Stanford University
Stanford, California, United States

Co-Author(s)

SL

Stanley Y. Liu, MD, DDS, FACS

Associate Professor of Otolaryngology
Stanford Hospital and Clinics
Redwood City, California, United States
Nazlie Taheri, DDS

Research Scholar
Stanford University
Napa, California, United States
AH

Allen Huang, DDS, MD

Clinical Instructor
Stanford Hospital
Palo Alto, California, United States
RC

Robson Capasso, MD

Professor
Stanford University
STANFORD, California, United States
yM

yifei Ma, MS

Statistician
Stanford Hospital and Clinics
Redwood City, California, United States
RR

Robert Riley, MD, DDS

Clinical Professor of Otolaryngology
Stanford Hospital and Clinics
Redwood City, California, United States

Abstract:

Purpose: Obstructive sleep apnea (OSA) is prevalent across all ethnicities. Maxillomandibular advancement (MMA) remains as one of the most effective surgical interventions for OSA. The heterogeneity of OSA makes it difficult to treat, and there are few studies evaluating sleep surgery among ethnic groups. The aim of this retrospective case-control study is to evaluate objective and subjective treatment outcomes of MMA across ethnicities, while accounting for variables including gender, body mass index (BMI) and age.

Methods: A retrospective review of subjects aged 18 years or older, who were diagnosed with OSA and subsequently treated with MMA from January of 2013 to December of 2021 were evaluated. Outcomes included the Apnea-Hypopnea Index (AHI), Oxygen Desaturation Index (ODI), Oxygen Saturation (SpO2) nadir, Nasal Obstruction Symptom Evaluation (NOSE), and Epworth Sleepiness Scale (ESS). The predictor variable was ethnicity of these subjects, while being matched for age, BMI, and gender.

Results: A total of 48 subjects were divided into Caucasian and non-Caucasian groups, with 24 subjects in each. AHI after MMA showed significant reductions both in Caucasian group (-39.58, p < 0.001) and in non-Caucasian group (-23.0, p < 0.001). ODI after MMA showed significant reductions both in Caucasian group (-15.8, p < 0.01) and in non-Caucasian group (-15.8, p < 0.001). SpO2 nadir after MMA showed significant improvement both in Caucasian group (+3.71, p < 0.05) and in non-Caucasian group (+4.5, p < 0.01). NOSE after MMA showed reduction in both Caucasian group (-6.68, p < 0.001) and non-Caucasian group (-7.40, p < 0.01). ESS after MMA showed reduction in both Caucasian group (-5.7, p < 0.05) and non-Caucasian group (-7.00, p < 0.01).

Conclusion: While MMA achieves significant surgical success across subjects of different ethnicities, there are differences in the pattern and timing of airway collapse resolution that warrants further research to optimize precision care.