title: Maxillary, mandibular, and chin advancement: treatment planning based on airway anatomy in obstructive sleep apnea.
abstract: Surgical correction of obstructive sleep apnea (OSA) syndrome involves understanding a number of parameters, of which the 3-dimensional airway anatomy is important. Visualization of the upper airway based on cone beam computed tomography scans and automated computer analysis is an aid in understanding normal and abnormal airway conditions and their response to surgery. The goal of surgical treatment of OSA syndrome is to enlarge the velo-oropharyngeal airway by anterior/lateral displacement of the soft tissues and musculature by maxillary, mandibular, and possibly, genioglossus advancement. Knowledge of the specific airway obstruction and characteristics based on 3-dimensional studies permits a directed surgical treatment plan that can successfully address the area or areas of airway obstruction. The end occlusal result can be improved when orthodontic treatment is combined with the surgical plan. The individual with OSA, though, is more complicated than the usual orthognathic patient, and both the medical condition and treatment length need to be judiciously managed when OSA and associated conditions are present. The perioperative management of the patient with OSA is more complex and the margin for error is reduced, and this needs to be taken into consideration and the care altered as indicated.
authors.affiliation: Stanford University, Palo Alto, CA, USA. sschendel@stanford.edu
authors.forename: Stephen
authors.initials: S
authors.lastname: Schendel
authors.forename: Nelson
authors.initials: N
authors.lastname: Powell
authors.forename: Richard
authors.initials: R
authors.lastname: Jacobson
mesh_terms: D000402:Airway Obstruction / Q000000981:diagnostic imaging / Q000601:surgery; D002508:Cephalometry; D002680:Chin / Q000601:surgery; D054893:Cone-Beam Computed Tomography; D004724:Endoscopy; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008313:Malocclusion, Angle Class III / Q000601:surgery; D019186:Mandibular Advancement; D008437:Maxilla / Q000601:surgery; D008875:Middle Aged; D009296:Nasal Cavity / Q000000981:diagnostic imaging; D009765:Obesity / Q000150:complications; D056948:Orthognathic Surgical Procedures / Q000379:methods*; D010347:Patient Care Planning; D010614:Pharynx / Q000000981:diagnostic imaging*; D017286:Polysomnography; D011182:Postoperative Care; D011300:Preoperative Care; D020181:Sleep Apnea, Obstructive / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014059:Tongue / Q000503:physiopathology; D014681:Velopharyngeal Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery