Is the bimaxillary advancement surgery usefull in pacients with obstructive sleep apnea-hypopnea syndrome(SAHS)?

The continuous positive airway pressure device(CPAP)is the most recognized treatment for the sleep apnea-hypopnea syndrome.Some patients with a particular facial profile and poor tolerance to CPAP could be candidates for surgery. OBJECTIVES: Assess the benefits of maxillary advancement surgery in patients with SAHS. MATERIAL AND METHODS: From 2011 to 2015, 25 patients with SAHS were studied for being candidates for corrective surgery.A pre and postoperative sleep study was conducted in all patients.The subsequent control was done from 6 to 12 months after surgery.Descriptive and retrospective statistical analyses were performed. RESULTS: Population description are shown . Daytime sleepiness decreased-15.3 initial Epworth(SD 1.2)vs. 6.5(SD 2.1)postoperative( p 0.000).The apnea hypopnea index(AHI)improved-48.4(SD 20.9)initial vs. 26.6 post surgery(SD 25.9)(p 0.005).26% patients showed no significant changes in AHI. No significant decrease in the average number of obstructive apneas is observed-193.4(SD 162.2) VS 102(SD 154.6)-,nor in the hypopneas number-80.7(SD 83.5)vs. 63.4(SD 40.5)-.The desaturation index,decreased from 44.02(SD 4.6)to 15.1(SD 4.3)(p 0.019).[Figure 1] At the beginning, all patients were treated with CPAP.After surgery just 5(33.3%)persist with CPAP,with partial tolerance,to an average pressure of 8.2 cmH20(SD 1.02). CONCLUSIONS: Bimaxillary advancement surgery may be an alternative treatment in patients with SAHS and a particular anatomical shape.