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An Evidence-Based, Multidisciplinary Textbook
Ki Beom Kim Reza Movahed Raman K. Malhotra Jerey J. Stanley
Editors
123
Management of Obstructive Sleep Apnea
Ki Beom Kim • Reza Movahed • Raman K. Malhotra • Jerey J. Stanley
Editors
Management of Obstructive Sleep Apnea
An Evidence-Based, Multidisciplinary Textbook
Editors
Ki Beom Kim Orthodontics Saint Louis University Orthodontics Saint Louis, MO USA
Reza Movahed Orthodontics Saint Louis University Orthodontics Saint Louis, MO USA
Raman K. Malhotra Washington University in St. Louis School ofMedicine Saint Louis, MO USA
Jeffrey J. Stanley Otolaryngology-Head and Neck Surgery University of Michigan–Ann Arbor Ann Arbor, MI USA
ISBN 978-3-030-54145-3 ISBN 978-3-030-54146-0 (eBook)
https://doi.org/10.1007/978-3-030-54146-0
© Springer Nature Switzerland AG 2021 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microlms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specic statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional afliations.
This Springer imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
V

Contents

I Principles and Fundamentals of OSA
1 Classication of Sleep-Related Breathing Disorders. . . . . . . . . . . . . . . . . . . . . . . . 3
Katelyn Smith
2
Pathophysiology of Obstructive Sleep Apnea (OSA). . . . . . . . . . . . . . . . . . . . . . . . 11
Frank Ralls, Lisa Cutchen, and Lee K. Brown
3
Health Consequences of Obstructive Sleep Apnea . . . . . . . . . . . . . . . . . . . . . . . . . 23
Joseph Roland D. Espiritu
4
Neurocognitive and Neuropsychological Eects of OSA . . . . . . . . . . . . . . . . . . . . 45
Andrew R. Spector and Thomas J. Farrer
5
Diagnostic Considerations in Metabolic Disease Associated
with Obstructive Sleep Apnea. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Raymond E. Bourey
57
II Diagnostic Considerations for OSA
6 Clinical Evaluation of the Obstructive Sleep Apnea Patient. . . . . . . . . . . . . . . . . 69
Raman K. Malhotra and Rocio Zeballos-Chavez
7
Diagnostic Testing for Obstructive Sleep Apnea. . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Meghna P. Mansukhani, Bhanu Prakash Kolla, and Kannan Ramar
8
Cone-Beam CT Use for Airway Imaging. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
Juan Martin Palomo, Tarek Elshebiny, and Kingman Strohl
9
Craniofacial Morphology Related to Obstructive Sleep Apnea:
Growth of Craniofacial Bones and the Upper Airway . . . . . . . . . . . . . . . . . . . . . . .
Su-Jung Kim and Ki Beom Kim
10
Orthodontics and Sleep- Disordered Breathing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135
Ki Beom Kim and Su-Jung Kim
11
Obstructive Sleep Apnea in the Setting of Mandibular
Condyle Resorption. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
W. Jonathan Fillmore
105
165
VI
Contents
III Non-surgical Management of OSA
12 Positive Airway Pressure for the Treatment of Obstructive
Sleep Apnea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Shalini Paruthi
13
Oral Appliance Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185
Marie Marklund
14
Other Therapies and Emerging Options for Management of OSA. . . . . . . . . . . . . . . . . . . . . . 213
Abbey Dunn and Neeraj Kaplish
177
IV Surgical Management of OSA
15 Surgical Management of OSA: Adenotonsillectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 225
Allison G. Ordemann and Ron B. Mitchell
16
Nasal Obstruction and Sleep- Disordered Breathing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 243
William C. Scott and David T. Kent
17
Palatal Surgery for OSA Patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 259
Chandra M. Cherukuri, Neeraj Kaplish, and Jeffrey J. Stanley
18
Hypopharyngeal Surgery for OSA Patients. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 269
Pratyusha Yalamanchi and Paul T. Hoff
19
Management of Obstructive Sleep Apnea (OSA) in Craniofacial Patients . . . . . . . . . . . . . . 281
Mikhail Daya and Jason E. Portnof
20
Miniscrew-Assisted Maxillary Expansion Techniques for Treatment
of Obstructive Sleep Apnea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Audrey Jung-Sun Yoon, Stanley Yung-Chuan Liu, and Christian Guilleminault
21
Orthognathic Surgical Considerations for Obstructive Sleep Apnea. . . . . . . . . . . . . . . . . . . 305
Yong-Il Kim, Ki Beom Kim, and Reza Movahed
22
Individualized Treatment Planning for Asian Adult Patients with Obstructive Sleep
Apnea Syndrome to Obtain Improvement of Respiratory Function and Facial Esthetics: Conventional Maxillomandibular Advancement (MMA) Versus Modied MMA with
Segmental Osteotomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Sung Ok Hong, Seung-Hak Baek, and Jin-Young Choi
293
323
V Maxillomandibular Advancement for OSA
23 Clinical, Occlusal, and Cephalometric Analyses of the OSA Patient . . . . . . . . . . . . . . . . . . . . 341
Larry Wolford
Contents
24 MRI Evaluation for Patients with TMJ Disorders and Obstructive
Sleep Apnea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Larry Wolford
25
Maxillary Surgical Procedures for Correction of Obstructive Sleep Apnea . . . . . . . . . . . . . 381
Will R. Allen and Matt J. Madsen
26
Mandibular Surgical Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 393
Larry Wolford
27
Counterclockwise Rotation of the Maxillomandibular Complex for the Correction
of Dentofacial Deformities and Sleep Apnea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Larry Wolford
28
Maxillomandibular Advancement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 437
Reza Movahed
29
Virtual Surgical Planning and Digital Workow for Concomitant Temporomandibular
Replacement and Maxillomandibular Advancement Surgery. . . . . . . . . . . . . . . . . . . . . . . . . .
Reza Movahed and Joseph W. Ivory
361
415
467
30
Postoperative Management of the Maxillomandibular Advancement Patient . . . . . . . . . 497
Zachary Brown and Daniel E. Perez
31
Post-surgical Myofunctional Therapy and Physical Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . 507
Joy L. Moeller, Cynthia Peterson, Licia Coceani Paskay, Samantha D. Weaver, and Soroush Zaghi
32
Complications Associated with Maxillomandibular Advancement. . . . . . . . . . . . . . . . . . . . . 515
Reza Movahed, Joseph W. Ivory, and Frank Delatour
33
Virtual Surgical Planning for Osseous Surgery to Manage Obstructive
Sleep Apnea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Christopher Viozzi
34
Temporomandibular Joint Reconstruction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 563
Louis G. Mercuri
35
Maxillomandibular Advancement Using Total Joint Replacement
for the Treatment of Obstructive Sleep Apnea. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Daniel E. Perez, Zachary Brown, and Edward Ellis III
545
571
36
Computational Fluid Dynamics and Morphometric Changes in OSA . . . . . . . . . . . . . . . . . . . 615
Ki Beom Kim, Reza Movahed, and Mark McQuilling
Supplementary Information
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .637
IX

Contributors

WillR.Allen Kentuckiana Oral and Maxillofacial Surgery, Louisville, KY, USA
wallen@gmail.com
Seung-HakBaek Department of Orthodontics, School of Dentistry, Dental Research Insti-
tute, Seoul National University, Seoul, South Korea
drwhite@snu.ac.kr
Raymond E. Bourey Division of Endocrinology, Diabetes, and Metabolism, Saint Louis
University, St. Louis, MO, USA
Raymond.Bourey@SLU.edu
Lee K. Brown Division of Pulmonary, Critical Care, and Sleep Medicine, Department of
Internal Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA
LKBrown@salud.unm.edu
Lisa Cutchen Division of Pulmonary, Critical Care, and Sleep Medicine, Department of
Internal Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA
Program in Sleep Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
ZacharyBrown Department of Oral and Maxillofacial Surgery, University of Texas Health
Science Center at San Antonio, San Antonio, TX, USA
Brownz@uthscsa.edu
ChandraM.Cherukuri Department of Family Medicine, University of Minnesota, Minneapo-
lis, MN, USA
Cherukuri2006@gmail.com
Jin-Young Choi Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental
Research Institute, Seoul National University, Seoul, South Korea
jinychoi@snu.ac.kr
MikhailDaya Movahed OMS, Chestereld, MO, USA
Mikhail.daya@gmail.com
Frank Delatour Department of Oral and Maxillofacial Surgery, William Beaumont Army
Medical Center, El Paso, TX, USA
delatour.frank@gmail.com
AbbeyDunn Clinical Instructor in Neurology, The University of Michigan, Ann Arbor, MI, USA
alecso@med.umich.edu
EdwardEllis III Department of Oral and Maxillofacial Surgery, University of Texas Health
Science Center at San Antonio, San Antonio, TX, USA
ellise3@uthscsa.edu
TarekElshebiny Case Western Reserve University, School of Dental Medicine– Department
of Orthodontics, Cleveland, OH, USA
tme18@case.edu
JosephRolandD.Espiritu SLUCare Sleep Disorders Center, Division of Pulmonary, Critical
Care, and Sleep Medicine, Saint Louis University School of Medicine, St. Louis, MO, USA
joseph.espiritu@health.slu.edu
X
Contributors
Thomas J. Farrer Department of Psychiatry and Behavioral Sciences, Duke University Medical Center,
Durham, NC, USA
Thomas.Farrer@duke.edu
W.JonathanFillmore Division of Oral and Maxillofacial Surgery, Department of Surgery, Mayo Clinic,
Rochester, MI, USA
llmore.jonathan@mayo.edu
ChristianGuilleminault Sleep Medicine Program, Stanford University Sleep Disorders Clinic, Stanford,
CA, USA
PaulT.Ho Department of Otolaryngology, University of Michigan, Ann Arbor, MI, USA
phoff@umich.edu
SungOkHong Department of Dentistry (Oral and Maxillofacial Surgery), School of Medicine, Catholic
Kwandong University, International St. Mary’s Hospital, Incheon, South Korea
Catherine.so.hong.sleepdoc@gmail.com
JosephW.IvoryM Department of Oral and Maxillofacial Surgery, William Beaumont Army Medical Cen-
ter, El Paso, TX, USA
sgtdabney@gmail.com
Neeraj Kaplish Department of Neurology, Michigan Medicine Sleep Disorders Laboratories, Michigan
Medicine, University of Michigan, Ann Arbor, MI, USA
neerajka@med.umich.edu neerajka@umich.edu
DavidT.Kent Department of Otolaryngology, Vanderbilt University, Nashville, TN, USA
david.kent@vanderbilt.edu
KiBeomKim Department of Orthodontics, Saint Louis University, St. Louis, MO, USA
kibeom.kim@health.slu.edu
Su-JungKim Department of Orthodontics, Kyung Hee University School of Dentistry, Seoul, South Korea
ksj113@khu.ac.kr
Yong-IlKim Department of Orthodontics, School of Dentistry, Pusan National University, Busan, South
Korea
kimyongil@pusan.ac.kr
BhanuPrakashKolla Center for Sleep Medicine, Mayo Clinic, Rochester, MN, USA
Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
kolla.bhanuprakash@mayo.edu
StanleyYung-ChuanLiu Department of Otolaryngology– Head and Neck Surgery, Stanford University
School of Medicine, Stanford, CA, USA
Ycliu@stanford.edu
MattJ.Madsen North County Oral and Facial Surgery Center, Escondido, CA, USA
madsen.matt@gmail.com
RamanK.Malhotra Sleep Medicine Section, Department of Neurology, Washington University in St. Louis,
St. Louis, MO, USA
raman.malhotra@wustl.edu
Contributors
MeghnaP.Mansukhani Center for Sleep Medicine, Mayo Clinic, Rochester, MN, USA
Mansukhani.Meghna@mayo.edu
M.Marklund Department of Odontology, Medical Faculty, Umeå University, Umeå, Sweden
marie.marklund@umu.se marie.marklund@me.com
Mark McQuilling Aerospace and Mechanical Engineering, Parks College of Engineering, Aviation, and
Technology, Saint Louis University, St. Louis, MO, USA
Mark.mcquilling@slu.edu
LouisG.Mercuri Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
TMJ Concepts, Ventura, CA, USA
Adjunct Professor, Department of Bioengineering, University of Illinois Chicago, Chicago, IL, USA
lgm@tmjconcepts.com
RonB.Mitchell Department of Otolaryngology, Head and Neck Surgery, UT Southwestern and Children’s
Medical Center Dallas, Dallas, TX, USA
Ron.mitchell@utsouthwestern.edu
JoyL.Moeller University of Southern California, Dental Hygiene Department, Private Practice of Myo-
functional Therapy, Los Angeles, CA, USA
joyleamoeller@aol.com
RezaMovahed Department of Orthodontics, Saint Louis University, St. Louis, MO, USA
Private Practice, St. Louis, MO, USA
movaheddmd@gmail.com
AllisonG.Ordemann University of Texas Southwestern Medical Center, Children’s Medical Center, Dallas,
TX, USA
Aordermann@gmail.com
JuanMartinPalomo Case Western Reserve University, School of Dental Medicine– Department of Ortho-
dontics, Cleveland, OH, USA
jmp5@case.edu
ShaliniParuthi Sleep Medicine and Research Center, Saint Luke’s Hospital, St. Louis, MO, USA
Department of Pediatrics, Saint Louis University School of Medicine, St. Louis, MO, USA
smparuthi@gmail.com
LiciaCoceaniPaskay Academy of Orofacial Myofunctional Therapy, Academy of Applied Myofunctional
Sciences, Los Angeles, CA, USA
lcpaskay@gmail.com
DanielE.Perez Department of Oral and Maxillofacial Surgery, University of Texas Health Science Center
at San Antonio, San Antonio, TX, USA
perezd5@uthscsa.edu
CynthiaPeterson Research Associate with the Breathe Institute, Private Practice, Salt Lake City, UT, USA
tmjhealingplan@gmail.com
JasonE.Portnof Department of Oral and Maxillofacial Surgery, Nova Southeastern University, Fort Lau-
derdale, FL, USA
jeportnof@gmail.com