Maxillomandibular Advancement Surgery: An Alternative Treatment Option for Obstructive Sleep Apnea

George, Louis T.; Barber, H. Dexter; Smith, Brian M.

doi:10.1016/j.cxom.2007.05.006

Cited by 15 publications

(12 citation statements)

References 15 publications

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“…This procedure is routinely performed to correct dysgnathia [7]. In the previous studies, the surgical technique and pre-and postoperative care in the treatment of OSA have been extensively described [12,13].…”

Section: Introductionmentioning

confidence: 99%

Management of Obstructive Sleep Apnea by Maxillomandibular Advancement Surgery

Bayar¹,

Zerener²

2017

Sleep Apnea - Recent Updates

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Obstructive sleep apnea (OSA is a common disorder characterized by recurrent episodes of partial or complete collapsibility of upper airway during sleep. The use of nocturnal positive airway pressure that pneumatically stents open the upper airway has been considered the irst-line treatment of OSA. However, in the last two decades, maxillomandibular advancement (MMA has been widely suggested as the most efective craniofacial surgical technique for the treatment of OSA in adults. It has been shown that the pharyngeal and hypopharyngeal airway could be enlarged with MMA surgery by physically expanding the facial skeletal framework. Tissue tension could be increased by forward movement of the maxillomandibular complex. Thus, collapsibility of the velopharyngeal and suprahyoid musculature could be decreased, and lateral pharyngeal wall collapse could be improved. Recent systematic reviews and meta-analyses showed that most of the subjects reported satisfaction after MMA with improvements in quality of life (QOL measures and most of OSA symptomatology. According to the recent updates, MMA appears to be the most successful surgical option for the treatment of OSA, and it could be an excellent alternative procedure for nonresponders, or deniers of ventilation therapy.

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Section: Introductionmentioning

confidence: 99%

Management of Obstructive Sleep Apnea by Maxillomandibular Advancement Surgery

Bayar¹,

Zerener²

2017

Sleep Apnea - Recent Updates

View full text Add to dashboard Cite

show abstract

“…It is well recognized that patients with maxillomandibular deficiencies will ultimately develop OSA; from this observation MMA is advocated for OSA treatment even in patients with normal skeletal proportion [59]. MMA will increase the posterior airway dimension by physically expanding the skeletal structure.…”

Section: Maxillomandibular Advancementmentioning

confidence: 99%

“…During MMA surgery, based on cephalometrics and model surgery, the mandible is advanced first; this is because the amount of advancement is arbitrary and without any considerations of the maxillary incisors esthetic position or functional occlusion. [1,59,68] Holty and Guilleminault published a meta-analysis of 53 reports describing 627 OSA patients with maxillomandibular advancement for the treatment of obstructive sleep apnea; they concluded that major and minor complication rates for MMA were 1.0% and 3.1%, respectively with cardiac complications as the most major complications. Facial paresthesia is the most common complication after MMA with 86% of cases resolved by 12 months after surgery.…”

Section: Maxillomandibular Advancementmentioning

confidence: 99%

“…Patients with poor response to MMA often have had UPPP. The possible cause is failure of the airway to stretch laterally in the retropalatal area caused by soft palate scarring from the previous surgery, making the tissues of the lateral pharyngeal walls stiffer and thus less responsive to advancement [1,59].…”

Section: Maxillomandibular Advancementmentioning

confidence: 99%

“…If the patient will undergo simultaneous MMA and soft tissue procedure such as UPPP or tongue reduction surgeries; temporary tracheostomy may be indicated to ensure patent airway. Other indications for temporary tracheostomy are difficult airway, RDI >60 and Sao2 <60, morbid obesity and significant craniofacial abnormality [1] [59]. MMA is considered one of the most successful treatment modalities for OSA after tracheostomy and CPAP [63] [64].…”

Section: Maxillomandibular Advancementmentioning

confidence: 99%

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