Airway changes and prevalence of obstructive sleep apnoea after bimaxillary orthognathic surgery with large mandibular setback.

This study used three-dimensional computed tomography and polysomnography to evaluate the effect of a large mandibular setback on the postoperative pharyngeal airway space and obstructive sleep apnoea (OSA). Twelve patients who underwent bimaxillary surgery for a mandibular setback movement of >9mm were included in this study. Changes in the pharyngeal airway space and polysomnography parameters based on the surgical movements were analyzed. The median mandibular setback movement was 11.08mm. The total pharyngeal, oropharyngeal, and hypopharyngeal volumes, and the retroglossal cross-sectional area were significantly decreased postoperatively (P=0.006; P=0.005; P=0.012; P=0.005, respectively). The apnoea-hypopnoea index (AHI) increased significantly after surgery (P=0.021). There were significant positive correlations between the preoperative inferiorly located hyoid bone and both AHI and respiratory disturbance index (RDI) postoperative (P=0.008 and P=0.027) and between the postoperative inferiorly dislocated retropalatal level and both AHI and RDI postoperative (P=0.002 and P=0.014). Four patients (33.3%) developed new onset OSA postoperatively. Large mandibular setback movements significantly reduced the pharyngeal airway space in the setting of bimaxillary surgery (P=0.006).

Hyponatremia associated with selective serotonin reuptake inhibitors, mirtazapine, and venlafaxine in Korean patients with major depressive disorder.

OBJECTIVE: Several reports of hyponatremia associated with the use of antidepressants such as selective serotonin reuptake inhibitors (SSRIs) have been published. This study compared the incidence of hyponatremia associated with SSRIs to that associated with mirtazapine and with venlafaxine in patients with major depressive disorder (MDD). MATERIAL AND METHODS: This retrospective study examined MDD in patients treated with an antidepressant over at least 4 weeks. Using medical records of 93 patients treated with an SSRI (paroxetine, sertraline, escitalopram, and fluoxetine), 76 patients treated with mirtazapine, and 71 patients treated with venlafaxine, we analyzed demographic variables and changes in serum sodium levels (at baseline and Week 4). RESULTS: Eight SSRIs group patients (8.6%) and three venlafaxine group patients (4.2%) exhibited mild hyponatremia during the study period. The SSRIs group's serum sodium level decreased only slightly, but significantly during treatment; however serum sodium levels in the mirtazapine and venlafaxine groups did not change significantly. The risk of developing hyponatremia while on an SSRI was greater in elderly subjects (60 years and older). CONCLUSION: These results indicate that, among patients with MDD, SSRIs treatment may be associated with decreased serum sodium levels, and the elderly patients are at greater risk for hyponatremia. Further prospective studies would help clarify the relative risks of hyponatremia among various antidepressants.