title: Maxillomandibular advancement as surgical treatment for obstructive sleep apnea in active duty military personnel: a retrospective cohort.
abstract: OBJECTIVE
  The objective of our study is to assess the surgical outcomes of active duty military personnel undergoing maxillomandibular advancement (MMA) for the treatment of obstructive sleep apnea.
  
  
  METHODS
  Pre- and postoperative data on 37 military personnel who underwent MMA were assessed for changes in apnea-hypopnea index (AHI) and minimum oxygen saturation. A surgical success was defined as a reduction of AHI by 50% or a postoperative AHI of <20.
  
  
  RESULTS
  83.7% had an AHI greater than 20 (n = 33; range 7.6-118) with a mean preoperative AHI of 50.5 per hour. The postoperative AHI decreased by 36.3 to a new value of 14.2 (p < 0.001). Most service members experienced a postoperative AHI of less than 20 (n = 28; 76%). Sixteen (43%) had a surgical cure (AHI < 5). The number of surgical successes for this study was 81% (n = 30). The mean minimal nocturnal oxyhemoglobin saturation did not significantly change from preoperative 85% (SD = 6.8%) to postoperative 86% (SD = 7%; p = 0.21).
  
  
  CONCLUSIONS
  MMA represents a viable surgical treatment option for military personnel in whom continuous positive airway pressure is either not tolerated or for those who desire a fully deployable status.
authors.affiliation: Oral and Maxillofacial Surgery Department, Madigan Healthcare System, Joint Base Lewis-McChord, 9040 Jackson Avenue, Tacoma, WA 98431, USA.
authors.forename: Marc M
authors.initials: MM
authors.lastname: Serra
authors.forename: David
authors.initials: D
authors.lastname: Greenburg
authors.forename: Megan
authors.initials: M
authors.lastname: Barnwell
authors.forename: David
authors.initials: D
authors.lastname: Fallah
authors.forename: Karen
authors.initials: K
authors.lastname: Keith
authors.forename: Vincent
authors.initials: V
authors.lastname: Mysliwiec
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019186:Mandibular Advancement / Q000379:methods*; D008437:Maxilla / Q000601:surgery*; D008875:Middle Aged; D008889:Military Personnel; D017286:Polysomnography; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult