Maxillofacial Surgery and OSAS

Question 1

Prevalence of Obstructive Sleep Apnea Syndrome (OSAS) is males and females

Answer 1

Males: 6-9%
Females: less than 4%

Question 2

what is apnea?

Answer 2

cessation of breathing for longer than 10 seconds

Question 3

what is hypopnea?

Answer 3

• decreased airflow of >70%

- any decreased airflow with desaturation of <90%

Question 4

what RDI defines sleep apnea?

*respiratory disturbance index

Answer 4

RDI > 15

Question 5

RDI for mild, moderate, and sever sleep apnea

*respiratory disturbance index

Answer 5

mild: 15-25
moderate: 26-40
severe: greater than 40

Question 6

what % of hypertensives have sleep apnea?

Answer 6

25%

Question 7

An RDI of what is an independent predictor of a myocardial infarction?

Answer 7

RDI >20

Question 8

T/F RDI severity is an independent predictor of a stroke

Answer 8

True

Question 9

What AI (apnea index) has a mortality rate of 37%?

Answer 9

> 20

Question 10

What is the rationale for an oral appliance to help apnea?

Answer 10

enlarges upper airway and improves upper airway muscle tone by advancing mandible

Question 11

4 success predictors for and an oral appliance?

Answer 11

1-lower baseline AHI
2- greater voluntary mandibular protrusion
3-larger positional components of OSA
4-lower BMI

Question 12

2 oral appliance indicators

Answer 12

Primary snorers, mild to moderate OSA

*if severe OSA, upper airway surgery may be supersede OA

Question 13

Does oral appliance compliance increase or decrease with time?

Answer 13

decrease

Question 14

7 oral appliance prerequisites

Answer 14

1-qualified dental practitioner
2-6-10 teeth
3-adequate jaw range of motion
4-no important TMD or bruxism
5-dexterity to place device
6-overnight titration by PSG is experimental 
7-dental follow up

Question 15

which genial surgery yielded more success, Genioglossus advancement or inferior boarder sliding osteotomy?

Answer 15

Genioglossus advancement

Question 16

which areas does maxillormandibular advancement effect?

Answer 16

nasopharynx, oropharynx, and hypopharynx

Question 17

what muscles does a maxillormandibular advancement effect in the hypopharynx?

Answer 17

pharyngeal sidewalls, stylohyoid muscle, and digastric muscles

Question 18

what are the two distinct groups of OSAS patients?

Answer 18

1- obese with normal face

2-no non-obese with facial deformaties

Question 19

what two films are taken for a ceph?

Answer 19

retruded mandible and end to end

Question 20

what percent of patients reported favorable, neutral changes OSAS?

Answer 20

56%, 33%