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Scientific Poster Session

9

ith the ability to sleep through the night, lifestylemprovement, and daytime sleepiness. The patientsated the questions on a scale from 0-8. In addition, aetrospective chart review was performed which mea-ured preoperative and postoperative respiratory distur-ance indices (RDI) and Epworth Sleep Scales (ESS).Method of Data Analysis: A mean was taken to

ompress all data, a t-test and ANOVA were employed,ith a p-value less than 0.05 to be statistically significant.Results: Pre- versus postoperative ESS for phase I

atients was 12.96 and 7.56. Pre- versus postoperativeSS for phase II patients was 16.29 and 5.47. Pre- versusostoperative RDI for phase I was 38.83 and 18.7. Pre-ersus postoperative RDI for phase II was 67.27 and0.46. Also, improvement average for phase II versushase I was 5.80 and 4.16. Satisfaction average for phaseI versus phase I was 5.75 and 5.0, p-value .258, nottatistically significant.

Conclusion: Reduction in the RDI to a value of lesshan or equal to 10, or of 50% or greater of the originals considered a success. In addition, a ESS value of lesshan 11 was considered successful. According to thisriteria, phase I was 61% (RDI) and 74% (ESS) successful.lso, phase II was 100% (RDI) and 94% (ESS) successful.verall, both phase I and phase II surgeries have shown

ncreased improvement and satisfaction average, withhase II surgery showing higher averages when com-ared to phase I.

References

Dattilo D, Drooger S. “Outcome assessment of patients undergoingaxillofacial procedures for the treatment of sleep apnea: comparison

f subjective and objective results. J Oral Maxillofac Surg. 2004;62:64-168Prinsell JR. “Maxillomandibular advancement surgery in site-specific

reatment approach for obstructive sleep apnea 50 consecutive pa-ients. Chest. 1999;116:1519-1524

OSTER 37valuation of the Nasal Airway andeptum Before and After Le Fort Isteotomy

akesh Shah, MD, DMD, Birmingham, AL (Waite P)

Statement of the Problem: Little research has beenone to examine the nasal septum after separation fromhe maxillary crest during Le Fort I procedures. Disrup-ion of the interface between the nasal septum and theaxillary crest can permanently change the nasal anat-

my. The changes in the nasal airway could potentiallyause ozena, nasal crusting, perforation, or septal devia-ion. The project was designed to evaluate changes ofhe nasal airway before and after Le Fort I osteotomy foraxillomandibular advancement in patients with ob-

tructive sleep apnea. a

0

Materials and Methods: Nasopharyngoscopy is rou-inely used to examine the airway before and approxi-ately 4-6 weeks after maxillomandibular advancement.

hotographs are taken to document changes in the nasalirway. The photographs of 8 patients status post max-llary and mandibular advancement were used to evalu-te the nasal airway for ozena, nasal crusting, perfora-ion, and septal deviation.

Method of Data Analysis: A nasopharyngoscopyorm was created to evaluate the nasal airway and sep-um for ozena, nasal crusting, perforation, and septaleviation. Nasopharyngoscopy photographs for 8 casesere reviewed and preoperative and postoperative

orms were completed.Results: The mean age of patients is 54 years with a

ange of 35-74 years. The mean time to post-operativeasopharyngoscopy was 40 days with a range of 27-50ays. At post-operative nasopharyngoscopy, 25% of pa-ients had nasal crusting and 62.5% of patients had aeptal perforation; 83.3% of patients with septal devia-ion prior to surgery were corrected during surgery. Noatients demonstrated post-operative ozena.Conclusion: A greater incidence of change in the

asal airway was shown than previously anticipated. Aubstantial change in the nasal airway was not expected,et this limited study shows otherwise. Further researchs necessary to determine whether the demonstratedeptal perforations will close and whether the nasalrusting will resolve.

References

Lehotay, Göde U, Wigand ME, Neukam FW. Nasal airway changes M.rbe, M. after Le Fort I—impaction and advancement: anatomical andunctional findings. Int J Oral Maxillofac Surg. 2001;30:123–129

Smith K, Heggie A. Vomero-sphenoidal disarticulation during the Leort I maxillary osteotomy. Journal of Oral and Maxillofacial Surgery.995;53:465-467

OSTER 38urvey of General Dentist and Oral andaxillofacial Surgeon Warfarin Protocol

or Tooth Extractionsyan D. Morris, DDS, Iowa City, IA (Morris R; Synan; Morgan T; Zeitler D; Qian F; Damiano P)

Statement of the Problem: Perioperative bleedingisk must be weighed against the risks of thromboem-olic events when warfarin anticoagulant therapy dis-ontinuation is considered. Dentists and dental special-sts may not be aware of the protocols recommended byurrent literature that discourage discontinuation of war-arin prior to dental treatment as patients may be placed

t unnecessary medical risk.

AAOMS • 2009