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Yang J, Tan ML, Ho JPTF, Rosenmöller BRAM, Jamaludin FS, van Riet TCT, de Lange J. Non-sleep related outcomes of maxillomandibular advancement, a systematic review. Sleep Med Rev 2024; 75:101917. [PMID: 38503113 DOI: 10.1016/j.smrv.2024.101917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 02/13/2024] [Accepted: 02/26/2024] [Indexed: 03/21/2024]
Abstract
Maxillomandibular advancement has been shown to be an effective treatment for obstructive sleep apnea; however, the literature focuses mainly on sleep-related parameters such as apnea-hypopnea index, respiratory disturbance index and Epworth sleepiness scale. Other factors that may be important to patients, such as esthetics, patient satisfaction, nasality, swallowing problems and so forth have been reported in the literature but have not been systematically studied. Together with an information specialist, an extensive search in Medline, Embase and Scopus yielded 1592 unique articles. Titles and abstracts were screened by two blinded reviewers. In total, 75 articles were deemed eligible for full-text screening and 38 articles were included for qualitative synthesis. The most common categories of non-sleep related outcomes found were surgical accuracy, facial esthetics, functional outcomes, quality of life, patient satisfaction, and emotional health. All categories were reported using heterogenous methods, such that meta-analysis could not be performed. There was lack of consistent methods to assess these outcomes. This work is the first to systematically review non-sleep related outcomes of maxillomandibular advancement. Despite growing interest in evaluating surgical outcomes through patient subjective experiences, this review points to the need of standardized, validated methods to report these outcomes.
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Affiliation(s)
- Joshua Yang
- Harvard School of Dental Medicine, Boston, MA, USA
| | - Misha L Tan
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centre, Location Academic Medical Center (AMC), and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, the Netherlands.
| | - Jean-Pierre T F Ho
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centre, Location Academic Medical Center (AMC), and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, the Netherlands; Department of Oral and Maxillofacial Surgery, Northwest Clinics, Alkmaar, the Netherlands
| | - Boudewijn R A M Rosenmöller
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centre, Location Academic Medical Center (AMC), and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, the Netherlands; Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, the Netherlands
| | - Faridi S Jamaludin
- Information Specialist Medical Library, Amsterdam University Medical Centre, Location Academic Medical Center (AMC), Amsterdam, the Netherlands
| | - Tom C T van Riet
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centre, Location Academic Medical Center (AMC), and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, the Netherlands
| | - Jan de Lange
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centre, Location Academic Medical Center (AMC), and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, the Netherlands
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Francisco I, Nunes C, Baptista Paula A, Marques F, Prata Ribeiro M, McEvoy M, Santos M, Oliveira C, Marto CM, Spagnuolo G, Carrilho E, Travassos R, Vale F. Patient-Reported Outcomes of Maxillomandibular Surgery for Obstructive Sleep Apnea Treatment: A Scoping Review. J Clin Med 2024; 13:1232. [PMID: 38592097 PMCID: PMC10932142 DOI: 10.3390/jcm13051232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 02/12/2024] [Accepted: 02/18/2024] [Indexed: 04/10/2024] Open
Abstract
(1) Background: The present scoping review aims to scrutinize all existing patient-reported outcomes and assess the perspectives of obstructive sleep apnea patients after maxillomandibular surgery. (2) Methods: The review was carried out according to the extensions for scoping reviews using the PRISMA-ScR guidelines. Several databases were used to carry out the initial search. This study included randomized controlled trials, cohort studies, cross-sectional and case-control studies. The included studies considered patients with obstructive sleep apnea who were submitted to orthognathic surgery as the main subjects, and the patient's perception of quality of life, satisfaction, treatment experience and side effects were assessed. (3) Results: From 1407 examined articles, a total of 16 were included. Most of the included studies used more than one questionnaire to assess quality of life, except for five articles. The most commonly referred instruments were the Epworth Sleepiness Scale, SF-36, the Functional Outcomes of Sleep and Ottawa Sleep Apnea. The most commonly assessed outcomes were sleep quality, daytime function, facial aesthetics, dental function and emotional health. (4) Conclusions: The number of variables that can be evaluated from a patient's perspective are endless, as are the tools available to assess them. Not all of these tools, which are generally questionnaires, assess all the various outcomes, and some do not compare the pre- and post-surgical situations. Most of them are generic and lack specificity for obstructive sleep apnea.
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Affiliation(s)
- Inês Francisco
- Institute of Orthodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal; (C.N.); (A.B.P.); (F.M.); (M.P.R.); (M.M.); (M.S.); (C.O.); (R.T.); (F.V.)
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal; (C.M.M.); (E.C.)
- Laboratory for Evidence-Based Sciences and Precision Dentistry, University of Coimbra, 3000-075 Coimbra, Portugal
- Centre for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-075 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3030-370 Coimbra, Portugal
| | - Catarina Nunes
- Institute of Orthodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal; (C.N.); (A.B.P.); (F.M.); (M.P.R.); (M.M.); (M.S.); (C.O.); (R.T.); (F.V.)
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal; (C.M.M.); (E.C.)
- Laboratory for Evidence-Based Sciences and Precision Dentistry, University of Coimbra, 3000-075 Coimbra, Portugal
- Centre for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-075 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3030-370 Coimbra, Portugal
| | - Anabela Baptista Paula
- Institute of Orthodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal; (C.N.); (A.B.P.); (F.M.); (M.P.R.); (M.M.); (M.S.); (C.O.); (R.T.); (F.V.)
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal; (C.M.M.); (E.C.)
- Laboratory for Evidence-Based Sciences and Precision Dentistry, University of Coimbra, 3000-075 Coimbra, Portugal
- Centre for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-075 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3030-370 Coimbra, Portugal
- Institute of Integrated Clinical Practice, Faculty of Medicine, University of Coimbra, 3004-531 Coimbra, Portugal
| | - Filipa Marques
- Institute of Orthodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal; (C.N.); (A.B.P.); (F.M.); (M.P.R.); (M.M.); (M.S.); (C.O.); (R.T.); (F.V.)
| | - Madalena Prata Ribeiro
- Institute of Orthodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal; (C.N.); (A.B.P.); (F.M.); (M.P.R.); (M.M.); (M.S.); (C.O.); (R.T.); (F.V.)
| | - Mariana McEvoy
- Institute of Orthodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal; (C.N.); (A.B.P.); (F.M.); (M.P.R.); (M.M.); (M.S.); (C.O.); (R.T.); (F.V.)
| | - Mariana Santos
- Institute of Orthodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal; (C.N.); (A.B.P.); (F.M.); (M.P.R.); (M.M.); (M.S.); (C.O.); (R.T.); (F.V.)
| | - Catarina Oliveira
- Institute of Orthodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal; (C.N.); (A.B.P.); (F.M.); (M.P.R.); (M.M.); (M.S.); (C.O.); (R.T.); (F.V.)
| | - Carlos Miguel Marto
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal; (C.M.M.); (E.C.)
- Laboratory for Evidence-Based Sciences and Precision Dentistry, University of Coimbra, 3000-075 Coimbra, Portugal
- Centre for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-075 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3030-370 Coimbra, Portugal
- Institute of Integrated Clinical Practice, Faculty of Medicine, University of Coimbra, 3004-531 Coimbra, Portugal
- Institute of Experimental Pathology, Faculty of Medicine, University of Coimbra, 3004-531 Coimbra, Portugal
| | - Gianrico Spagnuolo
- Department of Neurosciences, Reprodutive and Odontostomatological Sciences, University of Naples “Federico II”, 80138 Naples, Italy
| | - Eunice Carrilho
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal; (C.M.M.); (E.C.)
- Laboratory for Evidence-Based Sciences and Precision Dentistry, University of Coimbra, 3000-075 Coimbra, Portugal
- Centre for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-075 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3030-370 Coimbra, Portugal
- Institute of Integrated Clinical Practice, Faculty of Medicine, University of Coimbra, 3004-531 Coimbra, Portugal
| | - Raquel Travassos
- Institute of Orthodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal; (C.N.); (A.B.P.); (F.M.); (M.P.R.); (M.M.); (M.S.); (C.O.); (R.T.); (F.V.)
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal; (C.M.M.); (E.C.)
- Laboratory for Evidence-Based Sciences and Precision Dentistry, University of Coimbra, 3000-075 Coimbra, Portugal
- Centre for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-075 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3030-370 Coimbra, Portugal
| | - Francisco Vale
- Institute of Orthodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal; (C.N.); (A.B.P.); (F.M.); (M.P.R.); (M.M.); (M.S.); (C.O.); (R.T.); (F.V.)
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal; (C.M.M.); (E.C.)
- Laboratory for Evidence-Based Sciences and Precision Dentistry, University of Coimbra, 3000-075 Coimbra, Portugal
- Centre for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-075 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3030-370 Coimbra, Portugal
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