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What changes in maxillary morphology from distraction osteogenesis maxillary expansion (DOME) correlate with subjective and objective OSA measures?

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Abstract

Objectives

To correlate skeletal and airway measures on imaging with polysomnographic and self-reported measures after distraction osteogenesis maxillary expansion (DOME), in the effort to identify clinically relevant sites of expansion to guide treatment for adult patients with obstructive sleep apnea (OSA).

Materials and methods

This is a retrospective study reviewing subjects who underwent DOME and had the complete set of the following data: peri-treatment cone-beam computed tomography (CBCT) scans, polysomnography (PSG), Epworth Sleepiness Scale (ESS), and nasal obstruction symptom (NOSE) scores.

Results

Of 132 subjects who underwent DOME, 35 met inclusion criteria (71% men, mean age 27.7 ± 6.5 years, mean BMI 26.0 ± 6.4 kg/m2) and were enrolled in the study. There was a significant reduction in the NOSE score from 11.4 ± 5.5 to 3.6 ± 3.1, in the ESS score from 12.0 ± 4.6 to 7.1 ± 4.7, and in the apnea–hypopnea index (AHI) from 17.1 ± 15.8 to 7.01 ± 6.2 (p < 0.0001), after DOME. Nasal floor width at the nasopalatine canal level showed a statistically significant correlation with AHI reduction (p < .0001).

Conclusions

DOME is significantly associated with reduction of nasal obstruction, sleepiness, and severity of OSA. The findings suggest that expansion at the anterior third of the bony nasal passage, specifically where the nasopalatine canal is located predicts its clinical efficacy. This site may be a useful target anatomically via imaging.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Division of Sleep Medicine, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA

    Audrey Yoon

  2. Department of Orthodontics, Arthur A. Dugoni School of Dentistry at the University of the Pacific, San Francisco, CA, USA

    Audrey Yoon, Tae Keong Kim, Mai Nguyen, Hee Yeon Suh, Joorok Park & Heesoo Oh

  3. Division of Sleep Surgery, Department of Otolaryngology Head & Neck Surgery, School of Medicine, Stanford University, 801 Welch Road, Stanford, CA, 94305, USA

    Mohamed Abdelwahab & Stanley Yung-Chuan Liu

  4. Pediatric Dentistry and Orthodontics, Department of Clinical Science and Translational Medicine, University of Rome “Tor Vergata”, Rome, Italy

    Paola Pirelli

Authors
  1. Audrey Yoon
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  2. Tae Keong Kim
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  4. Mai Nguyen
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  9. Stanley Yung-Chuan Liu
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Corresponding authors

Correspondence to Audrey Yoon or Stanley Yung-Chuan Liu.

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Ethical approval

This study was approved by the Institutional Review Board of Stanford University (Protocol 36385, IRB-58401) and of the University of Pacific (IRB2020-74).

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For this type of retrospective studies, formal consent is not required. All authors have seen and approved the manuscript.

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The authors declare no competing interests.

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Yoon, A., Kim, T.K., Abdelwahab, M. et al. What changes in maxillary morphology from distraction osteogenesis maxillary expansion (DOME) correlate with subjective and objective OSA measures?. Sleep Breath 27, 1967–1975 (2023). https://doi.org/10.1007/s11325-022-02761-5

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  • DOI: https://doi.org/10.1007/s11325-022-02761-5

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