Work

Role of Pain in Adults Undergoing Soft Tissue and Maxillomandibular Advancement Surgery for Obstructive Sleep Apnea

Year: 2025

Type: article

Abstract: Objective: In adult patients who undergo soft tissue and maxillomandibular advancement (MMA) sleep surgery for obstructive sleep apnea (OSA), we identify preoperative pain diagnoses and postoperative pain medication dispensing patterns by surgery type. Methods: This retrospective cohort chart review study examines adults who underwent sleep surgery for OSA at an integrated healthcare delivery system (2009-2017). Data obtained from electronic sources included demographics, surgery type, presentation to the emergency department, hospital readmission, and postoperative medication dispensings. Results: , %) uvulopalatopharyngoplasty (1312, 57.3%) tonsillectomy (577, 25.2%), genioglossus muscle advancement (GA) alone or combined with MMA (108, 4.7%) and MMA alone (170, 7.4%), adenoidectomy (60, 2.6%), tongue and palate surgery (54, 2.4%), and tongue reduction (6, 0.3%). A total of 811 (35.5%) had a preoperative pain-related diagnosis, and 336 (14.7%) had a preoperative diagnosis of depression. Of the total cohort, 912 (39.9%) had a preoperative opioid prescription. In our cohort, 91.7% were prescribed outpatient opioid medication postoperatively. This varied by surgery type, with the highest proportion of opioid prescription dispensings observed in the soft tissue surgery group (non-MMA ± GA) and the lowest in the maxillofacial surgery group (MMA ± GA). In contrast, the maxillofacial surgery group had the highest proportion of nonopioid prescriptions dispensed, while the soft tissue surgery group had the lowest. Conclusions: Non-hypoglossal nerve stimulation (non-HGNS) sleep surgery for OSA is associated with high (nearly 92%) postoperative opioid dispensings. Adult patients undergoing non-HGNS sleep surgery are likely at increased risk of opioid complications given the high prevalence of preoperative opioid use, chronic pain, and depression. Level of Evidence: 4.

Source: Laryngoscope Investigative Otolaryngology

DOI: 10.1002/lio2.70322

Authors: Ghedak Ansari, Jeanne A. Darbinian, Samuel A. Collazo, Nikolas R. Block‐Wheeler, Megan L. Durr