Obstructive sleep apnoea: Does maxillomandibular advancement work?
Reviewed by Stuart Clark

This is a paper from the Netherlands reviewing 62 patients who underwent maxillomandibular advancement for moderate to severe obstructive sleep apnoea. The authors observed a 71% success rate with mean apnoea hypopnea index (AHI) reduction of 69%. There was no radiological difference between those who achieved a successful outcome following surgery and those that did not. There was a statistically significant failure in those patients with larger neck circumference and older patients. They regarded success as those with AHI changes that decreased beyond 50% and reduced to less than 20 events per hour. BMI, gender and ASA rating were not found to be significant. The authors then comment about complications and outline sensory disturbance which is a recognised complication of the procedure, regardless of indication. This adds further support that whilst being an invasive procedure producing facial changes (that are generally thought to be an improvement and well tolerated), mandibular and maxillary advancement surgery for sleep apnoea can be very successful. 

Assessment of obstructive sleep apnoea treatment, success or failure after maxillomandibular advancement.
de Ruiter MHT, Apperloo RC, Milstein DMJ, de Lange J.
INTERNATIONAL JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY
2017;46:1357–62.