No abstract

We evaluated the long-term impact of maxillomandibular advancement (MMA) surgery on the apneahypopnea index (AHI) and quality of life (QoL) in patients with obstructive sleep apnea syndrome (OSAS). The medical files of 12 OSAS patients undergoing MMA by one surgeon between 1995 and 1999 were retrospectively reviewed. Patients received a clinical assessment, polysomnography and QoL questionnaires as part of routine care preoperatively (n=12), within two year postoperatively (n=12), and again in 2016 (n=9). Successful surgical outcome was defined as an AHI decrease of > 50% and < 20/h. Of the 66.6% (8/12) of patients who were initially cured, 66.6% (4/6) remained stable at a median follow-up of 19 years. Only the two patients with the highest AHI showed abnormal Epworth Sleepiness scores. After convalescence, most patients reported stable symptomatic improvement. Esthetic changes were found acceptable and all but one patient stated that they would undergo the surgery again.We conclude that MMA is a safe and effective procedure. Ageing and weight gain might counterbalance the positive effects of surgery in the long run. We, therefore, suggest that five-annual re-evaluation should be scheduled since spontaneous AHI increase over time does not seem to be reflected by symptomatic changes.