title: Maxillomandibular advancement for obstructive sleep apnea syndrome treatment: Long-term results.
abstract: OBJECTIVE
  We evaluated the long term effectiveness of maxillomandibular advancement (MMA) for OSAS treatment patients. This retrospective study reviewed the patients treated by MMA for OSAS between 1995 and 2009. They were evaluated by complete polysomnography, cephalometry and quality of life questionnaire. The minimum follow up was 3 years. Success rate was defined by an IAH <10 with at least a 50% reduction.
  
  
  METHODS
  88 patients had MMA during this period. 34 accepted the evaluation (28 men, 6 women). Mean age was 52.4 ± 14. Mean follow-up was 12.5 years.
  
  
  RESULTS
  Long term success rate was 28% for the entire group, postoperative IAH was reduced between 50 and 80% for all the patients except one. Success rate was 100% for young patients (age < 45), with BMI <25 and IAH <45 and SNB <75° and narrow retrobasinlingual space (<8 mm) and with preoperative orthodontics. Esthetic and sleep results were better with a moderate maxillary advancement and anterior impaction. There was no skeletal relapse. The major postoperative complication was inferior alveolar nerve hypoesthesia.
  
  
  CONCLUSIONS
  MMA is an effective and stable treatment of OSAS in selected patients. Preoperative orthodontics is recommended.
authors.affiliation: Plastic and Maxillofacial Surgery Department, Grenoble University Hospital, BP 217, 38043, Grenoble Cedex, France.
authors.forename: Aurélie
authors.initials: A
authors.lastname: Vigneron
authors.affiliation: Sleep Laboratory, Grenoble University Hospital, BP 217, 38043, Grenoble Cedex, France. Electronic address: rtamisier@chu-grenoble.fr.
authors.forename: Renaud
authors.initials: R
authors.lastname: Tamisier
authors.affiliation: Plastic and Maxillofacial Surgery Department, Grenoble University Hospital, BP 217, 38043, Grenoble Cedex, France.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Orset
authors.affiliation: Sleep Laboratory, Grenoble University Hospital, BP 217, 38043, Grenoble Cedex, France.
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Pepin
authors.affiliation: Maxillofacial Surgery Department, Annecy Genevois Hospital, 1 avenue de l'hôpital, 74370, Epagny Metz-Tessy, France. Electronic address: gbettega@ch-annecygenevois.fr.
authors.forename: Georges
authors.initials: G
authors.lastname: Bettega
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging / Q000601:surgery; D019186:Mandibular Advancement / Q000379:methods*; D008875:Middle Aged; D017286:Polysomnography; D011859:Radiography; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Continuous positive airway pressure; Obstructive; Orthognathic surgery; Sleep apnea