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Maxillomandibular advancement

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https://www.readbyqxmd.com/read/27865790/maxillomandibular-advancement-surgery-for-patients-who-are-refractory-to-continuous-positive-airway-pressure-are-there-predictors-of-success
#1
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)...
October 26, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27728776/effect-of-genioplasty-on-the-pharyngeal-airway-space-following-maxillomandibular-advancement-surgery
#2
Hianne Miranda de Torres, José Valladares-Neto, Érica Miranda de 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...
September 15, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27720459/skeletal-surgery-for-obstructive-sleep-apnea
#3
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...
October 6, 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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/27269221/three-dimensional-evaluation-of-the-alar-cinch-suture-after-le-fort-i-osteotomy
#10
B van Loon, L Verhamme, T Xi, M J J de Koning, S J Bergé, T J J Maal
Orthognathic surgery has an influence on the overlying soft tissues of the translated bony maxillomandibular complex. Improvements in both function and facial appearance are the goals of surgery. However, unwanted changes to the soft tissues, especially in the nose region, frequently occur. The most common secondary change in the nasolabial region is widening of the alar base. Various surgical techniques have been developed to minimize this effect. The purpose of this study was to evaluate the changes in the nasal region due to orthognathic surgery, especially the alar width and nasal volume, using combined cone beam computed tomography (CBCT) and three-dimensional (3D) stereophotogrammetry datasets...
October 2016: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27225872/dynamic-comparison-of-pharyngeal-stability-during-sleep-in-patients-with-obstructive-sleep-apnea-syndrome-treated-with-maxillomandibular-advancement
#11
Ana Celia Faria, Luis Vicente Garcia, Antonio Carlos Santos, Alan Luiz Eckeli, Denny Marcos Garcia, Francisco Verissimo Mello-Filho
PURPOSE: To compare the dynamic differences occurring in the pharynx during sleep after maxillomandibular advancement (MMA) surgery for the treatment of patients with obstructive sleep apnea syndrome. METHODS: This was a prospective, cross-sectional study conducted on 20 patients (15 men and 5 women) with a polysomnography diagnosis of obstructive sleep apnea (OSA) submitted to surgical treatment with MMA. All patients were submitted to magnetic resonance (MR) during propofol-induced sleep before and 6 months after surgery...
May 26, 2016: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/27200238/orthognathic-consequences-of-sphincter-pharyngoplasty-in-cleft-patients-a-2-institutional-study
#12
Frances Yoshikane, Li Han Lai, Brian K Hui, Deborah B Martins, Gina Farias-Eisner, Rachel S Mandelbaum, Han Hoang, James P Bradley, Libby Wilson, Justine C Lee
BACKGROUND: Understanding long-term sequelae of cleft treatment is paramount in the refinement of treatment algorithms to accomplish optimized immediate and long-term outcomes. In this study, we reviewed sphincter pharyngoplasties as a method of velopharyngeal insufficiency (VPI) treatment in relationship to orthognathic surgery. METHODS: Cleft lip/palate and cleft palate patients, 15 years of age and older, were reviewed for demographics, VPI surgery, revisions, and subsequent orthognathic surgery at 2 institutions...
April 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27181624/morbidity-and-mortality-rates-after-maxillomandibular-advancement-for-treatment-of-obstructive-sleep-apnea
#13
Luis A Passeri, James G Choi, Leonard B Kaban, Edward T Lahey
PURPOSE: To compare morbidity and mortality rates in obstructive sleep apnea (OSA) versus dentofacial deformity (DFD) patients undergoing equivalent maxillofacial surgical procedures. PATIENTS AND METHODS: Patients with OSA who underwent maxillomandibular advancement with genial tubercle advancement in the Massachusetts General Hospital Department of Oral and Maxillofacial Surgery from December 2002 to June 2011 were matched to patients with DFD undergoing similar maxillofacial procedures during the same period...
October 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27028016/efficiency-of-bimaxillary-advancement-surgery-in-increasing-the-volume-of-the-upper-airways-a-systematic-review-of-observational-studies-and-meta-analysis
#14
Henrique Damian Rosário, Gustavo Mussi Stefan Oliveira, Irlan Almeida Freires, Felipe de Souza Matos, Luiz Renato Paranhos
Postsurgical changes of the airways have become a great point of interest because it has been reported that maxillomandibular advancement surgery can improve or eliminate obstructive sleep apnea; however, its treatment effectiveness is still controversial. The purpose of this systematic review and meta-analysis was to assess the effectiveness of maxillomandibular advancement surgery to increase upper airway volume in adults, comparing before and after treatment. Bibliographic searches of observational studies with no restriction of year or language were performed in the electronic databases PubMed, Scopus, ScienceDirect and SciELO for articles published up to April 2015...
March 30, 2016: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/26917205/quality-of-life-assessment-after-maxillomandibular-advancement-surgery-for-obstructive-sleep-apnea
#15
Kevin J Butterfield, Patricia L G Marks, Laurie McLean, Jack Newton
PURPOSE: Although maxillomandibular advancement (MMA) surgery is highly efficacious for the management of obstructive sleep apnea (OSA), little information exists regarding the subjective effect of this treatment modality. The present study was undertaken to investigate the effect of MMA on patient-perceived quality of life (QOL) in OSA. PATIENTS AND METHODS: A retrospective cohort study of patients treated with MMA for OSA from May 2010 to April 2015 was performed...
June 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/26868183/custom-machined-miniplates-and-bone-supported-guides-for-orthognathic-surgery-a-new-surgical-procedure
#16
Joan Brunso, Maria Franco, Thomas Constantinescu, Luis Barbier, Joseba Andoni Santamaría, Julio Alvarez
PURPOSE: Several surgical strategies exist to improve accuracy in orthognathic surgery, but ideal planning and treatment have yet to be described. The purpose of this study was to present and assess the accuracy of a virtual orthognathic positioning system (OPS), based on the use of bone-supported guides for placement of custom, highly rigid, machined titanium miniplates produced using computer-aided design and computer-aided manufacturing technology. MATERIALS AND METHODS: An institutional review board-approved prospective observational study was designed to evaluate our early experience with the OPS...
May 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/26810495/three-dimensional-assessment-of-anatomical-balance-and-oral-appliance-treatment-outcome-in-obstructive-sleep-apnoea
#17
Kate Sutherland, Andrew S L Chan, Peter A Cistulli
PURPOSE: Mandibular advancement splints (MAS) are an effective treatment for obstructive sleep apnoea (OSA). However, MAS are not equally efficacious across all patients and the reasons are not well understood. Craniofacial and upper airway structure individually influence MAS response. We aimed to assess anatomical balance, defined as the ratio of upper airway soft tissue (ST) volume to maxillomandibular enclosure volume, between MAS treatment responders and non-responders. METHODS: OSA patients (apnoea-hypopnea index (AHI) >10 h(-1)) were recruited for MAS treatment...
September 2016: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/26740522/efficacy-of-maxillomandibular-advancement-examined-with-drug-induced-sleep-endoscopy-and-computational-fluid-dynamics-airflow-modeling
#18
Stanley Yung-Chuan Liu, Leh-Kiong Huon, Tomonori Iwasaki, Audrey Yoon, Robert Riley, Nelson Powell, Carlos Torre, Robson Capasso
OBJECTIVES: To use drug-induced sedation endoscopy (DISE) and computational fluid dynamics (CFD) modeling to study dynamic airway and airflow changes after maxillomandibular advancement (MMA), and how the changes correlate with surgical success based on polysomnography parameters. STUDY DESIGN: Retrospective cohort study. SETTING: University medical center. METHODS: DISE was rated with the VOTE (velum, oropharynx, tongue, epiglottis) classification, and CFD was used to model airflow velocity and negative pressure exerted on pharyngeal wall...
January 2016: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/26700261/hypoglossal-nerve-stimulation-rescue-surgery-after-multiple-multilevel-procedures-for-obstructive-sleep-apnea
#19
Madeleine Strohl, Kingman Strohl, J Martin Palomo, Diana Ponsky
Hypoglossal nerve stimulation (HNS) is a new procedure offered for the treatment of moderate-to-severe obstructive sleep apnea (OSA) that has been shown to decrease the severity and symptoms of OSA in select patients. We report on a case of a patient with persistent symptoms and findings of OSA despite a history of multiple multilevel procedures, including an uvulopalatopharyngoplasty (UPPP) with revision, a genioglossus advancement, and a maxillomandibular advancement. The patient then underwent HNS with significant improvement of his symptoms and severity...
January 2016: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/26616028/upper-airway-dimensions-in-patients-undergoing-orthognathic-surgery-a-systematic-review-and-meta-analysis
#20
REVIEW
I O Christovam, C O Lisboa, D M T P Ferreira, A A Cury-Saramago, C T Mattos
The objective of this systematic review was to evaluate the effect of different types of orthognathic surgery on the dimensions of the upper airways assessed using three-dimensional images. An electronic search was performed in Cochrane Library, Medline, Scopus, VHL, Web of Science, and the System for Information on Grey Literature in Europe, ending January 2015. Inclusion criteria encompassed clinical studies in humans, patient age >15 years, patients submitted to maxillary or mandibular advancement or setback surgery, isolated or in combination, and presentation of airway measures, specifically volume and/or minimum cross-sectional area (CSA), obtained from computed tomography or magnetic resonance imaging...
April 2016: International Journal of Oral and Maxillofacial Surgery
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