Maxillo-Mandibular Advancement Surgery for Obstructive Sleep Apnea in Adults: Evidence from an Overview of Systematic Reviews and Meta-Analyses

Abstract

MMA surgery is used for the treatment of OSA. An overview of systematic reviews published regarding the single-stage MMA in the management of OSA was conducted. The Cochrane Library and PubMed/MEDLINE databases were searched. A qualitative data analysis was undertaken, with quality assessment completed using the Assessment of Multiple Systematic Reviews (AMSTAR) tool. The initial search yielded 814 articles, the titles and abstracts of 787 articles were screened and the full texts of 128 articles were assessed for eligibility. Twenty-five articles met the inclusion criteria while thirteen were excluded because the systematic reviews included surgical procedures other than single-stage MMA. Finally, twelve systematic reviews were analyzed. The AMSTAR score ranged from 2-11. Only two of the SRs included randomized controlled trials (RCTs), while the majority of the included primary studies were retrospective in design. The umbrella review presents significant insights into the strengths and limitations of the current systematic reviews on the role of single-stage MMA in the treatment of OSA, uncovers gaps in knowledge, and highlights the need for higher-quality prospective studies to strengthen the evidence base.