Effectiveness of maxillo-mandibular advancement in obstructive sleep apnea patients with and without skeletal anomalies

• Published in: International journal of oral and maxillofacial surgery 2010-06, Vol.39 (6), p.541-547
• Main Authors: Ronchi, P, Novelli, G, Colombo, L, Valsecchi, S, Oldani, A, Zucconi, M, Paddeu, A
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Cephalometry; Chin - surgery; Dentistry; Female; Humans; Jaw Fixation Techniques - instrumentation; Male; Malocclusion, Angle Class II - complications; Malocclusion, Angle Class II - surgery; Mandibular Advancement; Maxilla - surgery; maxillo-mandibular advancement; Medical sciences; Micrognathism - complications; Micrognathism - surgery; Middle Aged; Nose - surgery; OSAS; Otorhinolaryngology. Stomatology; Patient Satisfaction; Pharynx - anatomy & histology; Pharynx - diagnostic imaging; Pneumology; Radiography; Respiratory system : syndromes and miscellaneous diseases; Retrospective Studies; Sleep Apnea, Obstructive - complications; Sleep Apnea, Obstructive - surgery; Surgery; Surveys and Questionnaires; Treatment Outcome
• ISSN: 0901-5027; 1399-0020
• DOI: 10.1016/j.ijom.2010.03.006

Abstract This study evaluates the effectiveness of maxillo-mandibular advancement (MMA) in patients with obstructive sleep apnea syndrome (OSAS), even those without skeletal anomalies, indicating the possibility of extending this procedure to more patients. Two groups with different skeletal patterns were studied pre- and post-surgery. Group 1 (11 patients) had severe or moderate OSAS and maxillo-mandibular hypoplasia and/or mandibular deformities (SNA angle 78° or less or SNA angle > 78° but with SNB < 65° and severe skeletal class II malocclusion). Group 2 (11 patients) had severe or moderate OSAS without maxillo-mandibular hypoplasia or deformity (SNA angle > 80°, dental class I occlusion). Analysis comprised: apnea hypopnea index (AHI), posterior airway space (PAS), SNA and SNB angles, Epworth sleepiness scale (ESS), body mass index (BMI), and a subjective standardized questionnaire about aesthetic appearance. All patients had increased PAS width and complete remission of objective and subjective OSAS symptoms evaluated by AHI and ESS. Results in both groups are comparable. Data were analysed using t -test; p < 0.005 was statistically significant. All patients were satisfied with the functional and aesthetic results. MMA is effective in patients with severe or moderate OSAS, even in those without skeletal and/or occlusal anomalies and can be considered in more patients.