Surgery vs ventilation in adult severe obstructive sleep apnea syndrome

Claudio Vicini, Iacopo Dallan, Aldo Campanini, Andrea De Vito, Francesca Barbanti, Gianluca Giorgiomarrano, Marcello Bosi, Giuseppe Plazzi, Federica Provini, Elio Lugaresi

Research output: Contribution to journalArticle


Background and purpose: Management of severe obstructive sleep apnea-hypopnea syndrome (OSAHS) is challenging and needs multidisciplinary cooperation. Ventilation is considered the gold standard of treatment in severe OSAHS. The aim of the study was to compare the therapeutical efficacy of a type of surgery (maxillomandibular advancement [MMA]) vs a ventilatory treatment modality (autotitrating positive airway pressure [APAP]). Materials and methods: At the ENT Department of Forlì Hospital (University of Pavia), in strict cooperation with the Sleep Lab of the University of Bologna, a prospective randomized controlled trial was designed and performed. After fully informing them, 50 consecutive patients who have severe OSAHS were enrolled and randomized into a conservative (APAP) or surgical (MMA) section. Demographic, biometric, polysomnogram (PSG) and Epworth Sleepiness Scale profiles of the 2 groups were statistically not significantly different. Results: One year after surgery or continuous APAP treatment, both groups showed a remarkable improvement of mean Apnea-Hypopnea Index (AHI) and Epworth Sleepiness Scale levels; the degree of improvement was not statistically different. Conclusions: Given the relatively small sample of subjects studied and the relatively brief follow-up, MMA proved to be a valuable alternative therapeutical tool in our adult and severe OSAHS patient group, with a success rate not inferior to APAP.

Original languageEnglish
Pages (from-to)14-20
Number of pages7
JournalAmerican Journal of Otolaryngology - Head and Neck Medicine and Surgery
Issue number1
Publication statusPublished - Jan 2010

ASJC Scopus subject areas

  • Otorhinolaryngology

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