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Management of obstructive sleep apnoea

an update on the role of distraction osteogenesis

Leung, Yiu Yan; Lai, Karen Kar Yan

Current Opinion in Otolaryngology & Head and Neck Surgery: August 2018 - Volume 26 - Issue 4 - p 214–220
doi: 10.1097/MOO.0000000000000465
FACIAL PLASTIC SURGERY: Edited by Travis T. Tollefson
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Purpose of review This article reviews the current literature on the use of distraction osteogenesis as a treatment for patients with obstructive sleep apnoea (OSA). We reviewed the indications, surgical protocols and outcomes for distraction osteogenesis in paediatric and adult OSA cases described in the literature.

Recent findings There is evidence that distraction osteogenesis is effective in treating children with OSA as a result of underdevelopment of jaws such as those with craniofacial syndromes. Distraction osteogenesis appears to be the only available treatment that prevents tracheostomy in some of these cases, or allows decannulation after distraction. For adult OSA patients, distraction osteogenesis is reported to be reserved for challenging cases such as OSA as a consequence of temporomandibular joint ankylosis. It is used where conventional orthognathic surgery is not feasible. The studies reported high success rate/cure rate of OSA after distraction osteogenesis. Technological advances such as three-dimensional printing assist the execution of an accurate distraction process.

Summary Distraction osteogenesis appears to be an effective treatment for paediatric OSA patients with craniofacial anomalies, and is used in selected cases of adult with severe OSA. With the improvement in distraction device designs and computer technology, distraction osteogenesis may play a bigger role in the treatment of OSA.

Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Pokfulam, Hong Kong

Correspondence to Yiu Yan Leung, Oral and Maxillofacial Surgery, Prince Philip Dental Hospital, 34 Hospital Road, Pokfulam, Hong Kong. Tel: +852 28590511; fax: +852 2857 5570; e-mail: mikeyyleung@hku.hk

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