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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 first-line treatment of OSA. However, in the last two decades, maxillomandibular advancement (MMA) has been widely suggested as the most effective 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.

Management of Obstructive Sleep Apnea by Maxillomandibular Advancement Surgery