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Tesi etd-07242020-140932


Thesis type
Tesi di laurea magistrale LM6
Author
GIUSTI, ROSA
URN
etd-07242020-140932
Title
Short time assessment of quality of life after maxillo-mandibular advancement in Obstructive Sleep Apnea patients.
Struttura
RICERCA TRASLAZIONALE E DELLE NUOVE TECNOLOGIE IN MEDICINA E CHIRURGIA
Corso di studi
MEDICINA E CHIRURGIA
Supervisors
relatore Prof. Gabriele, Mario
relatore Dott. Brevi, Bruno Carlo
correlatore Prof. Faraguna, Ugo
Parole chiave
  • maxillofacial surgery
  • surgical treatment of obstructive sleep apnea
  • short time assessment
  • maxillo- mandibular advancement
  • MMA
  • OSAS
  • QoL
  • quality of life
  • obstructive sleep apnea syndrome
Data inizio appello
14/09/2020;
Consultabilità
Parziale
Data di rilascio
14/09/2023
Riassunto analitico
Obstructive Sleep Apnea Syndrome (OSAS) is a common chronic disease characterised by repeated episodes of apnea/ hypopnea during the sleeping time due to a mechanical collapse of upper airways.
It represent one of the most frequent sleep disorder, with a worldwide prevalence estimated around 1 billion of which about 425 millions meet the requirements to start treatment; in spite of this, it is still often undiagnosed.
OSAS has repercussions not only on patients’ health, exposing them to cardiovascular, neurological and metabolic risk, but it also affects their quality of life and entire society because of the symptoms, especially daytime sleepiness that impacts on work performance and increase risk of road accidents.
Maxillary mandibular advancement (MMA) is a proven surgical treatment for the treatment of obstructive sleep disorders.

This study focuses on the OSAS patients’ perception of their quality of life (QoL), evaluating the impact of MMA on physical and mental health, in a short time after treatment.
In addition, it is proposed to assess which symptoms affects QoL more and test a possible correlation between AHI (apnea/hypopnea index) and the reported symptomatology.

Data were collected from questionnaires: State Trait Anxiety Inventory-1 and 2 (STAI-Y1 and STAI-Y2) for anxious symptomatology, Beck Depression Inventory version II (BDI-II) and Center of Epidemiologic studies- Depression Sacle (CES-D) for depressive symptoms, Epworth Sleepiness Scale (ESS) to investigate daytime sleepiness, Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality, Berlin Questionnaire (BQ) for obstructive related symptoms, reduced Morningness- Eveningness Questionnaire (rMEQ) for chronotype, GerdQ, to assess the presence of gastroesophageal, International Index of Erectile Function (IIEF-15) and Female Sexual Function Index (FSFI) to investigate sexual function in both sexes.
Quality of life was assessed by a physical component score (PCS) and a mental component score (MCS); other data as age, weight, high e AHI were recorded.
Resulted eligible for this study a total of 15 patients (of which 13 males and 2 females); questionnaires were given in two tranches, the first around one month before the surgery ad the second around two/three months after surgery.

The results showed statistically significant improvements in the results after the MMA intervention: BMI (p=0.014), ESS (p<0.001), PSQI (p=0.003), BQ (p<0.001), BDI (p=0.003), CESD (p<0.001) and MCS (p=0.008); there was also an improvement, although not statistically significant, in IIEF.
Significant correlations were found between MCS index and the pre and post treatment differences of the variables BMI, BDI; with the variation of the MCS between before and after surgery correlate dPSQI and dBDI; the reduction of BMI was seen to correlate significantly with that of ESS (p<0.05), BDI (p=0.011) and CESD (p=0.16) changes.

In conclusion, it can be said that in the short period following surgery there has been a significant improvement in the quality of life in terms of psychic health, with a reduction in BMI, daytime sleepiness, obstructive symptoms (snoring and apnea) and depression and an improvement, although not statistically significant, in male sexual function. The quality of psychic health before surgery seems to be more involved in the post-treatment outcome of sleep quality and depressive symptoms.
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