title: Surgical treatment modality for facial esthetics in an obstructive sleep apnea patient with protrusive upper lip and acute nasolabial angle.
abstract: For patients with severe obstructive sleep apnea syndrome (OSAS), maxillomandibular advancement (MMA) offers a good treatment option by physically expanding the skeletal framework. However, facial esthetics can be aggravated by MMA in patients with OSAS who have a normally positioned maxilla, a protrusive upper lip, and an acute nasolabial angle. Therefore, surgical treatment planning should be customized according to diverse skeletodental and soft-tissue patterns to produce a favorable change in facial esthetics and sleep function in patients with OSAS. In this case report, good treatment results were achieved in a young female patient with OSAS and skeletal Class II, a normally positioned maxilla, a protrusive upper lip, and acute nasolabial angle by impaction of the maxilla, autorotation/advancement of the mandible, and advancement of the chin. A customized flowchart for surgical treatment planning in OSAS that considers facial esthetics was suggested.
authors.affiliation: Department of Orthodontics, School of Dentistry, Seoul National University, Seoul, South Korea.
authors.forename: Hyo-Won
authors.initials: HW
authors.lastname: Ahn
authors.forename: Il-Sik
authors.initials: IS
authors.lastname: Cho
authors.forename: Keun-Chul
authors.initials: KC
authors.lastname: Cho
authors.forename: Jin-Young
authors.initials: JY
authors.lastname: Choi
authors.forename: Jin-Woo
authors.initials: JW
authors.lastname: Chung
authors.forename: Seung-Hak
authors.initials: SH
authors.lastname: Baek
mesh_terms: D002508:Cephalometry; D004955:Esthetics, Dental; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D019186:Mandibular Advancement; D008437:Maxilla / Q000601:surgery; D017090:Occlusal Splints; D009960:Oropharynx / Q000601:surgery; D056948:Orthognathic Surgical Procedures; D019340:Osteotomy, Le Fort; D059229:Osteotomy, Sagittal Split Ramus; D057887:Overbite / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D010347:Patient Care Planning; D017286:Polysomnography; D011859:Radiography; D020181:Sleep Apnea, Obstructive / Q000209:etiology / Q000601:surgery*; D013705:Temporomandibular Joint Disorders / Q000150:complications / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult