(1315) Postoperative Sinonasal Function after Maxillomandibular Advancement for Obstructive Sleep Apnea

Introduction: Maxillomandibular advancement (MMA) is an effective procedure in patients with severe obstructive sleep apnea (OSA); however, postoperative sinonasal function is currently understudied.

Methods: A prospective study at a tertiary referral center was performed. The Sino-nasal Outcome Test (SNOT-22) was collected preoperatively and postoperatively at one week, one month, and three months. Repeated measures of ANOVA with post hoc analyses using a Bonferroni adjustment were performed for total score, total sinonasal score (sum of questions 1-12), and each sinonasal symptom at one month and three months.

Results: A total of 14 patients were included. Median age was 53.5 years (range 31-65), and 21.4% were female. Mean postoperative AHI (8.5 ± 6.7), ODI (3.4 ± 2.6), oxygen nadir (86.6 ± 2.9), Epworth (2.6 ± 2.3), and NOSE (11.3 ± 17.5) were calculated. Mean total scores differed significantly between time points for both one month (p = 0.001) and three months (p < 0.001), with post hoc analyses showing a significant decrease preoperatively to one month (p < 0.001) and three months (p = 0.029). Mean total sinonasal scores differed significantly between time points for both one month (p = 0.013) and three months (p = 0.048), but post hoc analyses did not show a significant decrease at one month (p = 0.236) and three months (p = 0.323). Need to blow nose, nasal blockage, cough, and ear pain were the individual symptoms that differed significantly between time points for one month and three months, with nasal blockage showing a significant decrease preoperatively to one month (p = 0.004).

Conclusions: Patients who underwent MMA at this tertiary referral center did not show evidence of worsening sinonasal function, with some evidence that sinonasal function may improve after MMA. Long-term follow-up with more patients is needed to support these findings.