[Maxillomandibular advancement]

Obstructive sleep apnea (OSA) is a common and often underdiagnosed disorder associated with increased risk of cardiovascular, metabolic, and neurocognitive complications. For patients who are non-compliant or respond insufficiently to continuous positive airway pressure (CPAP) or a mandibular advancement device, different surgical alternatives are available. One option is maxillomandibular advancement (MMA), which is a well-established and highly effective procedure that increases upper airway volume by advancing both jaws. Meta-analyses and long-term studies demonstrate a reduction of the apnea-hypopnea index (AHI) by more than 50%, frequently with normalization of sleep parameters, improved quality of life and high patient satisfaction. Although MMA is recommended in international guidelines and acknowledged in Swedish national recommendations, the procedure remains underutilized in Sweden. This report presents two illustrative cases and highlights the need for increased awareness, national coordination, and broader clinical implementation of MMA.