Use of primary screening tools as a pre-surgical evaluation protocol for obstructive sleep apnea in maxillofacial surgery patients

Siddharth desai, Shubha laxmi, Siva Bharani

College of dental sciences, davangere, Karnataka, India

ABSTRACT

Obstructive Sleep Apnea (OSA) is implicated in the etiology of numerous serious health problems. The aim of this study is to screen suspected cases of OSA, create awareness amongst patients at risk and propose a cost effective and easy screening protocol for OSA. An observational study which included screening of patients posted for surgery, at department of Oral and Maxillofacial Surgery using detailed history and clinical examination, STOP BANG questionnaire, lateral cephalogram and overnight pulse oximetry in a step wise manner. The data obtained was analysed to determine the relationship of each test parameter to the final risk scoring and overnight Oxygen Desaturation Index (ODI). In this study, over a period of one year, out of 124 cases, 40 cases (32.3%) were categorized as intermediate or high-risk cases for presence OSA, according to the STOP-BANG questionnaire. 11 cases (26.2%) were screened as high-risk based on ODI value. There was a strong correlation between risk factors such as snoring, obesity, male gender, excessive daytime sleepiness, hypertension and OSA. We can categorize the patients as low, intermediate and high-risk cases and accordingly advise them for further polysomnography studies, lifestyle modifications or oral appliances and take the necessary peri-operative precautions for intermediate or high-risk cases where surgery is mandatory.

Keywords:

Obstructive Sleep Apnea, STOP-BANG questionnaire, Overnight Pulse Oximetry, Oxygen Desaturation Index