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Updated: Jul 19, 2026

Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Total airway obstruction after maxillomandibular advancement surgery for obstructive sleep apnea
Patrick W Hogan1, Maged Argalious
1Division of Anesthesiology and Critical Care Medicine, Case Western Reserve University.
Background:
Maxillomandibular advancement surgery is a surgical option for treating obstructive sleep apnea, especially in patients intolerant to, or noncompliant with, continuous positive airway pressure.
Methods:
We describe a patient who underwent maxillomandibular advancement surgery, met criteria for tracheal extubation, and subsequently developed total airway obstruction immediately upon extubation.
Results:
Before extubation, an airway exchange catheter was used and reintubation occurred without difficulty. The patient was brought back to the operating room for evacuation of a hypopharyngeal hematoma, as well as revision and replacement of fractured hardware.
Conclusions:
Nasopharyngolaryngoscopy should be performed routinely before extubating these patients to evaluate for pharyngeal edema and hematoma formation.
Implications:
Maxillomandibular advancement (MMA) surgery is increasingly used as a surgical option in the treatment of obstructive sleep apnea. We report a case of life-threatening airway obstruction after MMA and discuss the etiology of airway compromise after these surgeries.
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