[Treatment of obstructive sleep apnea with methods of orthognathic surgery]

The only surgical means available up to now for treating obstructive sleep apnea syndrome (OSAS) consisted in uvulopalatopharyngoplasty (UPPP), which failed to produce satisfactory results. The ultima ratio frequently resorted to was tracheotomy with all its medical and social drawbacks. Complete advancement of the maxillomandibular complex opens up new avenues for the treatment of upper airways obstruction. The present report is on 13 patients operated for polysomnographically established OSA. The maxillomandibular complex was brought as far forward as possible and esthetically justifiable. This operation was occasionally combined with other procedures to enhance upper airways function, such as conchotomy, palatopharyngoplasty, chin graft and reduction of tongue size. In 85% of the cases the apnea and hypopnea index (RDI) could be lowered to below 10 per hour sleep, i.e. these patients were cured.