Surgery that moves both jaws forward, known as maxillomandibular advancement (MMA), is a significantly effective and safe treatment for obstructive sleep apnea (OSA) that results in benefits including improved breathing, daytime wakefulness, and quality of life as well as lower cardiovascular risk, according to a multi-institute team of researchers.
MMA should be regarded as the preferred treatment for patients with moderate to severe OSA who cannot stick with continuous positive airway pressure (CPAP) treatment or who declined CPAP as a long-term treatment, the researchers concluded.
During OSA, airway muscles, large tonsils, the tongue, or excess tissue obstruct the airway, resulting in breathing dangerously stopping and starting during sleep. OSA can result in excessive daytime sleepiness, lower quality of life, and impaired cognitive function that impacts daily activities. It also is associated with high blood pressure, diabetes, and cardiovascular disease.
The study involved 30 adult patients with severe OSA, most of them overweight and male, who underwent MMA because they were unable to continue CPAP therapy or because they declined to use CPAP long-term. CPAP, the standard accepted therapy for OSA, blows air to keep the airways open. Data were recorded before and after surgery.
After MMA, the patients experienced significant improvements in sleep-disordered breathing, sleepiness, sleep-specific quality of life, general quality of life, and performance related to mental processes (neurocognitive performance) as well as lower blood pressure.
Nearly 94% of patients met normal levels of sleepiness after surgery. Also, few adverse events related to treatment were found. The results were similar to those of other studies that have associated MMA with few major complications and few treatment-related adverse events.
The researchers note that this is the only multicenter prospective study that has comprehensively assessed MMA’s effectiveness and safety by measuring the subjective treatment-related symptoms as well as the objective physical findings after surgery.
Plus, the researchers say, its results show that patients have few adverse treatment-related symptoms or abnormal physical findings after MMA, which minimally impacts their quality of life and masticatory function.
The study, “Maxillomandibular Advancement Improves Multiple Health-Related and Functional Outcomes in Patients With Obstructive Sleep Apnea: A Multicenter Study,” was published by the Journal of Oral and Maxillofacial Surgery.
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