Maxillomandibular Advancement Improves Multiple Health-Related and Functional Outcomes in Patients With Obstructive...

Area of Science:

• Sleep Medicine
• Surgical Innovation
• Cardiovascular Health

Background:

• Obstructive sleep apnea (OSA) is a prevalent condition associated with significant morbidity.
• Current treatments for OSA have limitations, necessitating exploration of alternative surgical interventions.
• Maxillomandibular advancement (MMA) is a surgical technique aimed at increasing the upper airway dimensions.

Purpose of the Study:

• To evaluate the effectiveness and safety of maxillomandibular advancement (MMA) in treating patients with obstructive sleep apnea (OSA).
• To assess the impact of MMA on key health parameters including sleepiness, quality of life, and cardiovascular risk.
• To investigate the effects of MMA on neurocognitive performance.

Main Methods:

• A prospective multicenter cohort study was conducted involving adult patients undergoing MMA for OSA.
• Outcomes including sleepiness (Epworth Sleepiness Scale), quality of life (Functional Outcomes of Sleep Questionnaire), apnea-hypopnea index, blood pressure, and neurocognitive performance (psychomotor vigilance testing) were measured preoperatively and postoperatively.
• Descriptive and bivariate statistical analyses were performed to assess changes in outcome measures.

Main Results:

• The study included 30 adult patients (63% male; mean age 45.9 years).
• Significant improvements were observed in sleepiness (ESS score decreased from 13.3 to 4.9, P < .001), quality of life (FOSQ score increased from 14.1 to 18.3, P < .001), and apnea-hypopnea index (decreased from 39.6 to 7.9 events/hour, P < .001).
• Improvements were also noted in diastolic blood pressure (P = .025) and neurocognitive performance (PVT, P = .04), with minimal adverse events reported.

Conclusions:

• Maxillomandibular advancement (MMA) is a highly effective and safe surgical treatment for obstructive sleep apnea (OSA).
• MMA leads to predictable and significant improvements in patient sleepiness, quality of life, and sleep-disordered breathing.
• The procedure also demonstrates benefits in reducing cardiovascular risk and enhancing neurocognitive function.