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Surgical technique for maxillomandibular advancement (MMA) to improve obstructive sleep apnea is discussed in this article. Surgically advancing the maxillomandibular complex by at least 1 cm provides tension on the soft tissues in the airway from the soft palate to the base of the tongue, widening the pharynx in the anteroposterior dimension, but most importantly laterally. The tissues would no longer be able to collapse and obstruct the pharynx. Postoperative polysomnography in patients who have MMA is comparable to that of patients using continuous positive airway pressure therapy appropriately. Primary surgical MMA is highly efficacious. More long-term studies are needed for validating this valuable surgical alternative to continuous positive airway pressure therapy. [ABSTRACT FROM AUTHOR]

Maxillomandibular advancement enlarges the entire pharynx by pulling anteriorly the bony squelettal structures. It is performed in sleep apnea patients who refuse or fail to use continuous positive airway pressure. It is constantly associated to esthetic modifications but not necessarily disgraceful. Perioperative breathing complications can occur which implies a good cooperation between the surgeon and the anesthesiologists in the operating room and in the following hours in the ICU. Hypoesthesia of the lower lip and chin is the most frequent long term complication. Nevertheless, bimaxillary advancement is one of the most effective treatments for OSAS even on a long term basis. [Copyright &y& Elsevier]

Maxillofacial skeletal deficiency in the saggital and frontal plane has been shown to be a major contributing factor in obstructive sleep apnea syndrome. Despite the success of conventional surgical procedures in maxillofacial skeletal expansion, increasing interests have been generated in the use of distraction osteogenesis for skeletal expansion for the treatment of obstructive sleep apnea syndrome. This article will discuss the method as well as relevant results. [Copyright &y& Elsevier]