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Maxillomandibular advancement

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https://www.readbyqxmd.com/read/28417661/corrective-nasal-surgery-after-maxillomandibular-advancement-for-obstructive-sleep-apnea-experience-from-379-cases
#1
Stanley Yung-Chuan Liu, Pi-Jung Lee, Michael Awad, Robert W Riley, Soroush Zaghi
Objective Efficacy of maxillomandibular advancement (MMA) in the treatment of obstructive sleep apnea (OSA) is associated with degree of maxillary advancement. Large maxillary advancement leads to profound changes of the nasolabial region. We present the incidence and indications of post-MMA corrective nasal surgery in a large cohort. Study Design Case series with chart review. Setting University medical center. Subjects and Methods A total of 379 subjects with OSA underwent MMA at Stanford Hospital (surgeons: S...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28294946/continuing-the-original-stanford-sleep-surgery-protocol-from-upper-airway-reconstruction-to-upper-airway-stimulation-our-first-successful-case
#2
Stanley Yung Liu, Robert Wayne Riley
In 1993, a surgical protocol for dynamic upper airway reconstruction in patients with obstructive sleep apnea (OSA) was published, and it became commonly known as the Stanford phase 1 and 2 sleep surgery protocol. It served as a platform on which research and clinical studies have continued to perfect the surgical care of patients with OSA. However, relapse is inevitable in a chronic condition such as OSA, and a subset of previously cured surgical patients return with complaints of excessive daytime sleepiness...
February 20, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28293491/disparities-in-utilization-of-jaw-surgery-for-treatment-of-sleep-apnea-a-nationwide-analysis
#3
Ravi K Garg, Ying Shan, Jeffrey A Havlena, Ahmed M Afifi
BACKGROUND: Maxillomandibular advancement has been shown to be one of the most effective operations for management of severe obstructive sleep apnea, yet pharyngeal surgery is more commonly performed. The goal of this study was to identify socioeconomic factors associated with this phenomenon. METHODS: Patients aged 14 or older with a primary hospital diagnosis of sleep apnea were identified using the National Inpatient Sample from 2005 to 2012. ICD9 codes were used to determine whether a pharyngeal or jaw procedure was performed...
December 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28258532/counterclockwise-maxillomandibular-advancement-a-choice-for-chinese-patients-with-severe-obstructive-sleep-apnea
#4
Silong Wei, Yong Zhang, Xiaojing Guo, Wenwen Yu, Meng Wang, Kan Yao, Hongxia Sun, Hua Zhang, Xiaofeng Lu
PURPOSE: Maxillomandibular advancement (MMA) is an effective alternative for treating severe obstructive sleep apnea (OSA). However, the promotion of MMA in China is limited by many Chinese patients having a convex facial profile. To achieve maximal upper airway enlargement without an esthetic disaster, we added counterclockwise rotation of the maxillomandibular complex (MMC) in the routine MMA. In this paper, we have evaluated the objective and subjective outcomes of this technology...
March 3, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28123648/effectiveness-of-maxillomandibular-advancement-mma-surgery-in-sleep-apnea-treatment-case-report
#5
Otávio Ferraz, Thais M Guimarães, Rowdley R Rossi, Paulo A Cunali, Cibele Dal Fabbro, Cauby M Chaves, Milton Maluly, Lia Bittencourt, Sergio Tufik
Obstructive sleep apnea (OSA) is characterized by episodes of pharyngeal collapse during sleep. Craniofacial alterations such as retrognathia are often found in OSA patients. Maxillomandibular advancement (MMA) surgeries increase the pharyngeal space and are a treatment option for OSA. The aim of this study was to present a successful case of MMA surgery in the treatment of OSA. A patient with moderate OSA (apnea-hypopnea index (AHI)=25.2) and mandibular retrognathism and Maxillomandibular asymmetry underwent MMA surgery...
July 2016: Sleep Science
https://www.readbyqxmd.com/read/28111283/morphological-impact-on-patients-of-maxillomandibular-advancement-surgery-for-the-treatment-of-obstructive-sleep-apnea-hypopnea-syndrome
#6
Thibaut Beranger, Emilie Garreau, Joël Ferri, Gwenael Raoul
INTRODUCTION: The aim of this study is to evaluate the experience of patients who have benefited from maxillomandibular advancement surgery for the treatment of obstructive sleep apnea-hypopnea syndrome (OSAHS), and also the morphological modifications measured on pre- and postoperative lateral headfilms. PATIENTS AND METHODS: Twenty-three patients aged 24 to 64 (M=46.8) who had undergone bimaxillary advancement osteotomy for the treatment of OSAHS filled in a questionnaire concerning their overall satisfaction following surgery, the modification of their facial appearance as perceived by themselves and their family and friends, the change in their smile, and the slimmer and more youthful appearance of their face...
March 2017: International Orthodontics
https://www.readbyqxmd.com/read/28063275/a-survey-of-sleep-medicine-physician-perceptions-on-the-surgical-treatment-of-obstructive-sleep-apnea
#7
Jonathan J Swope, Marcus A Couey, James W Wilson, Jonathon S Jundt
PURPOSE: Surgical treatment for obstructive sleep apnea (OSA) varies by specialty. Our survey sought to answer 3 principal questions: 1) To which surgical specialists are sleep physicians referring patients for upper airway surgery? 2) Which surgical treatment do sleep specialists find to be most effective in treating OSA? 3) Do sleep medicine physicians believe that maxillomandibular advancement (MMA) is worthwhile to patients who are surgical candidates? MATERIALS AND METHODS: We formulated a cross-sectional survey...
December 18, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28062177/maxillomandibular-advancement-for-obstructive-sleep-apnea-syndrome-treatment-long-term-results
#8
Aurélie Vigneron, Renaud Tamisier, Emmanuelle Orset, Jean-Louis Pepin, Georges Bettega
PURPOSE: We evaluated the long term effectiveness of maxillomandibular advancement (MMA) for OSAS treatment patients. This retrospective study reviewed the patients treated by MMA for OSAS between 1995 and 2009. They were evaluated by complete polysomnography, cephalometry and quality of life questionnaire. The minimum follow up was 3 years. Success rate was defined by an IAH <10 with at least a 50% reduction. MATERIAL AND METHODS: 88 patients had MMA during this period...
December 7, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28005735/subtypes-of-maxillomandibular-advancement-surgery-for-patients-with-obstructive-sleep-apnea
#9
Won-June Lee, Dong-Hyun Hwang, Stanley Yung-Chuan Liu, Su-Jung Kim
Maxillomandibular advancement (MMA) surgery, which is the most effective treatment modality for patients with moderate-to-severe obstructive sleep apnea with apparent skeletal discrepancies, has been modified in conjunction with segmental osteotomies, counterclockwise rotation of maxillomandibular complex, and other adjunctive procedures. However, any single type of MMA could not treat or cure all the patients with obstructive sleep apnea showing different dentofacial and pharyngeal patterns. We aimed to suggest critical decision factors for the selective application of MMA subtypes, categorized as straight MMA with genioplasty, rotational MMA, segmental MMA, and segmental-rotational MMA, in the surgical treatment objective process: anteroposterior position of maxilla, upper lip projection, overjet, lower incisor inclination as sagittal factors, and upper incisor exposure and occlusal plane angle as vertical factors...
November 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27997447/combined-counterclockwise-maxillomandibular-advancement-and-uvulopalatopharyngoplasty-surgeries-for-severe-obstructive-sleep-apnea
#10
Wenwen Yu, Meng Wang, Jiande He, Liyan Lu, Ming Cai, Hongxia Sun, Xiaofeng Lu
As the most effective surgical technique maxillomandibular advancement (MMA) has been used to treat severe obstructive sleep apnea (OSA) in adults, particularly for those who are intolerant of continuous positive airway pressure. Yet for large-scale advancement, it is faced with esthetic problems with marked skeletal protrusion especially for people with convex facial profile. In this study, the authors performed counterclockwise MMA combined with quantified uvulopalatopharyngoplasty (UPPP) surgeries on Chinese adult patients with severe OSA, in order to initially explore the efficacy of these procedures on Chinese populations and provide evidence for esthetic advantages...
March 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27957370/refractory-obstructive-sleep-apnea-in-a-patient-with-diffuse-idiopathic-skeletal-hyperostosis
#11
Ara Darakjian, Ani B Darakjian, Edward T Chang, Macario Camacho
Diffuse Idiopathic Skeletal Hyperostosis (DISH) can cause ossification of ligaments and may affect the spine. We report a case of obstructive sleep apnea in a patient with significant upper airway narrowing secondary to cervical DISH. This patient had an initial apnea-hypopnea index (AHI) of 145 events/hour and was treated with uvulopalatopharyngoplasty, genial tubercle advancement, hyoid suspension, septoplasty, inferior turbinoplasties, and radiofrequency ablations to the tongue base which reduced his AHI to 40 events/hour...
2016: Case Reports in Otolaryngology
https://www.readbyqxmd.com/read/27865790/maxillomandibular-advancement-surgery-for-patients-who-are-refractory-to-continuous-positive-airway-pressure-are-there-predictors-of-success
#12
Igor Makovey, Anita Valanju Shelgikar, Jeffrey J Stanley, Adina Robinson, Sharon Aronovich
PURPOSE: This pilot study was conducted to determine the effectiveness of maxillomandibular advancement (MMA) in the treatment of patients with moderate to severe obstructive sleep apnea (OSA). The predictive value of clinical, radiographic, and treatment-related variables also was investigated in relation to the success or failure of MMA as treatment for OSA. MATERIALS AND METHODS: A retrospective study design was used to assess the outcomes of MMA in patients with moderate to severe OSA (apnea hypopnea index [AHI] >15 events per hour) at the University of Michigan (Ann Arbor, MI)...
February 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27728776/effect-of-genioplasty-on-the-pharyngeal-airway-space-following-maxillomandibular-advancement-surgery
#13
Hianne Miranda Torres, José Valladares-Neto, Érica Miranda Torres, Rogério Zambonato Freitas, Maria Alves Garcia Silva
PURPOSE: To evaluate the effect of genioplasty on the size of the pharyngeal airway space (PAS) in a sample of patients without obstructive sleep apnea syndrome (OSAS) undergoing maxillomandibular advancement (MMA) surgery. MATERIALS AND METHODS: Lateral cephalometric radiographs of 52 patients who underwent orthognathic surgery for MMA were obtained before (T1) and after (T2) surgery. The radiographs were digitized and the anteroposterior dimensions of the PAS were measured at the nasopharynx, oropharynx, and hypopharynx levels...
January 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27720459/skeletal-surgery-for-obstructive-sleep-apnea
#14
REVIEW
José E Barrera
Multilevel surgery has been established as the mainstay of treatment for the surgical management of obstructive sleep apnea (OSA). Combined with uvulopalatopharyngoplasty, tongue-base surgeries, including the genioglossus advancement (GA), sliding genioplasty, and hyoid myotomy and suspension, have been developed to target hypopharyngeal obstruction. Total airway surgery consisting of maxillomandibular advancement (MMA) with/without GA has shown significant success. Skeletal procedures for OSA with or without a palatal procedure is a proven technique for relieving airway obstruction during sleep...
December 2016: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/27673521/obstructive-sleep-apnea-in-adults-the-role-of-upper-airway-and-facial-skeletal-surgery
#15
Ravi K Garg, Ahmed M Afifi, Ruston Sanchez, Timothy W King
Obstructive sleep apnea represents a large burden of disease to the general population and may compromise patient quality of life; workplace and automotive safety; and metabolic, cardiovascular, and neurocognitive health. The disease is characterized by repetitive cycles of upper airway collapse resulting from a lack of pharyngeal airway structural support and loss of muscle tone among upper airway dilators. Polysomnography serves as the gold standard for diagnosis of obstructive sleep apnea and the apnea-hypopnea index is the most commonly used metric for quantifying disease severity...
October 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27617808/subtypes-of-maxillomandibular-advancement-surgery-for-patients-with-obstructive-sleep-apnea
#16
Won-June Lee, Dong-Hyun Hwang, Stanley Yung-Chuan Liu, Su-Jung Kim
Maxillomandibular advancement (MMA) surgery, which is the most effective treatment modality for patients with moderate-to-severe obstructive sleep apnea with apparent skeletal discrepancies, has been modified in conjunction with segmental osteotomies, counterclockwise rotation of maxillomandibular complex, and other adjunctive procedures. However, any single type of MMA could not treat or cure all the patients with obstructive sleep apnea showing different dentofacial and pharyngeal patterns. We aimed to suggest critical decision factors for the selective application of MMA subtypes, categorized as straight MMA with genioplasty, rotational MMA, segmental MMA, and segmental-rotational MMA, in the surgical treatment objective process: anteroposterior position of maxilla, upper lip projection, overjet, lower incisor inclination as sagittal factors, and upper incisor exposure and occlusal plane angle as vertical factors...
September 9, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27603361/distraction-osteogenesis-as-a-treatment-of-obstructive-sleep-apnea-syndrome-a-systematic-review
#17
REVIEW
Wai Kin Tsui, Yanqi Yang, Lim Kwong Cheung, Yiu Yan Leung
BACKGROUND: To conduct a systematic review to answer the clinical question "What are the effectiveness of mandibular distraction osteogenesis (MDO) and its complications to treat patients with obstructive sleep apnea syndrome (OSAS)?". METHODS: A systematic search including a computer search with specific keywords, reference list search, and manual search were done. Relevant articles on MDO were assessed and selected in 3 rounds for final review based on 5 predefined inclusion criteria and followed by a round of critical appraisal...
September 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27428915/midfacial-protraction-with-skeletal-anchorage-after-pterygomaxillary-separation
#18
Luciane Macedo de Menezes, Rogério Belle de Oliveira, André Weissheimer, Rafael Linard Avelar
The present article reports the treatment of a 7-year-old girl with maxillary hypoplasia associated with multiple tooth agenesis through maxillary protraction with skeletal anchorage and pterygomaxillary separation. Two titanium mini-plates were placed in the lateral region of the nasal cavity and used as anchorage for maxillary protraction with a reverse-pull facemask. Pterygomaxillary separation was also performed to enhance the effects of maxillary protraction. One week after surgery, 300 g of force was applied on each side to protract the maxilla...
September 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27370206/idiopathic-intracranial-hypertension-eliminated-by-counterclockwise-maxillomandibular-advancement-a-case-report
#19
Deborah Wardly, Larry M Wolford, Venkat Veerappan
INTRODUCTION: Obstructive sleep apnea (OSA) is a secondary cause of intracranial hypertension (IH). Decreased jugular venous drainage has been seen in patients with idiopathic IH. CLINICAL PRESENTATION: A complex case of a 48-year-old female whose idiopathic IH was put into remission after counterclockwise maxillomandibular advancement (CC-MMA), despite persistence of her OSA. CONCLUSION: This case highlights the relationship between OSA and IH and points to the significant morbidity that can result from mild OSA and from what are considered borderline intracranial pressures...
July 1, 2016: Cranio: the Journal of Craniomandibular Practice
https://www.readbyqxmd.com/read/27358005/-aesthetic-success-in-genioplasties-procedures-criteria
#20
Monique Raberin
Maxillomandibular dysmorphia may be associated with structural chin pathologies. Three-dimensional jaws displacements have limits. Specific genioplasty is an additional surgical mean for soft tissues profile normalization. Osteotomy line is examined according an incline angle and a possible lateral extension, as chin wing technique, improves facial shape. Cephalometric set-up with R line analyzes surgical chin movements and impact of lower incisors labial inclination on lower lip and mentolabial fold after advancement genioplasty...
June 2016: L' Orthodontie Française
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