Maxillomandibular advancement versus multilevel surgery for treatment of obstructive sleep apnea: A systematic review and meta-analysis

Ning Zhou, Jean Pierre T.F. Ho, Zhengfei Huang, René Spijker, Nico de Vries, Ghizlane Aarab, Frank Lobbezoo, Madeline J.L. Ravesloot, Jan de Lange

Research output: Contribution to journalReview articleAcademicpeer-review

28 Citations (Scopus)

Abstract

Multilevel surgery (MLS) and maxillomandibular advancement surgery (MMA) are two established options in surgical management of obstructive sleep apnea (OSA), which target different levels of airway obstruction. The objective of this review was to comparatively evaluate the clinical efficacy and safety of MMA and MLS in the treatment of OSA. MEDLINE and Embase databases were searched for studies on MMA and/or MLS in OSA patients. Twenty MMA studies and 39 MLS studies were identified. OSA patients who underwent MMA showed significant improvements in AHI, LSAT, ODI, and ESS by −46.2/h, 13.5%, −30.3/h, and −8.5, respectively. The pooled rates of surgical success and cure for MMA were 85.0% and 46.3%, respectively. Patients who underwent MLS showed significant improvements in AHI, LSAT, ODI, and ESS by −24.7/h, 8.7%, −19.1/h, and −5.8, respectively. The pooled surgical success and cure rates for MLS were 65.1% and 28.1%, respectively. The rates of major complication of MMA and MLS were 3.2% and 1.1%, respectively, and the rate of minor complication of MMA was higher than that of MLS. We conclude that both MMA and MLS are effective treatment options for OSA. Compared to MLS, MMA may be more effective in improving OSA. However, the complication rate of MMA is higher.

Original languageEnglish
Article number101471
Pages (from-to)1-13
Number of pages13
JournalSleep Medicine Reviews
Volume57
Early online date17 Mar 2021
DOIs
Publication statusPublished - 1 Jun 2021

Keywords

  • Maxillomandibular advancement
  • Meta-analysis
  • Multilevel surgery
  • Obstructive sleep apnea
  • Surgery
  • Systematic review

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