title: Total airway obstruction after maxillomandibular advancement surgery for obstructive sleep apnea.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Anesthesiology and Critical Care Medicine, Case Western Reserve University.
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Hogan
authors.forename: Maged
authors.initials: M
authors.lastname: Argalious
mesh_terms: D000402:Airway Obstruction / Q000209:etiology*; D006801:Humans; D008297:Male; D019186:Mandibular Advancement / Q000009:adverse effects* / Q000379:methods; D008437:Maxilla / Q000601:surgery*; D008875:Middle Aged; D020181:Sleep Apnea, Obstructive / Q000601:surgery*