title: Morphological impact on patients of maxillomandibular advancement surgery for the treatment of obstructive sleep apnea-hypopnea syndrome.
abstract: BACKGROUND
  The aim of this study is to evaluate the experience of patients who have benefited from maxillomandibular advancement surgery for the treatment of obstructive sleep apnea-hypopnea syndrome (OSAHS), and also the morphological modifications measured on pre- and postoperative lateral headfilms.
  
  
  METHODS
  Twenty-three patients aged 24 to 64 (M=46.8) who had undergone bimaxillary advancement osteotomy for the treatment of OSAHS filled in a questionnaire concerning their overall satisfaction following surgery, the modification of their facial appearance as perceived by themselves and their family and friends, the change in their smile, and the slimmer and more youthful appearance of their face. Measurements of bone and skin points were also performed on lateral cephalograms before and after surgery so as to assess the advancement of the bony bases (maxillary, mandibular and chin advancement) and the impact on soft tissue by analysis of the skin profile.
  
  
  RESULTS
  A total of 91.3% of the patients were satisfied overall following the surgical procedure; 78.3% considered that their faces were improved or unchanged; 39.1% found their faces slimmer and 34.8% thought they looked more youthful. Average maxillary, mandibular and chin advancements with respect to the base of the skull were, respectively, 7.4mm, 11.1mm and 14.1mm. Advancement of the stomion point with respect to the Frankfurt plane was 8.3mm on average, reflecting a significant forward movement of the upper and lower lips.
  
  
  CONCLUSIONS
  Despite greater maxillary and mandibular advancements than in traditional orthognathic surgery, patients reacted positively to these morphological changes, considering in more than a third of cases that their faces looked slimmer or more youthful. It can thus be concluded that overall satisfaction is high, with a morphological impact that is satisfactory and well-accepted by patients postoperatively.
authors.affiliation: Département universitaire de chirurgie maxillo-faciale et stomatologie, hôpital Roger-Salengro, CHU de Lille, rue Émile-Laine, 59037 Lille, France. Electronic address: beranger.thibaut@gmail.com.
authors.forename: Thibaut
authors.initials: T
authors.lastname: Beranger
authors.affiliation: Département universitaire de chirurgie maxillo-faciale et stomatologie, hôpital Roger-Salengro, CHU de Lille, rue Émile-Laine, 59037 Lille, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Garreau
authors.affiliation: Département universitaire de chirurgie maxillo-faciale et stomatologie, hôpital Roger-Salengro, CHU de Lille, rue Émile-Laine, 59037 Lille, France; Association internationale de médecine orale et maxillo-faciale, 7, bis rue de la Créativité, 59650 Villeneuve-d'Ascq, France; Université Lille Nord de France, UDSL, 1, rue Lefèvre, 59000 Lille, France.
authors.forename: Joël
authors.initials: J
authors.lastname: Ferri
authors.affiliation: Département universitaire de chirurgie maxillo-faciale et stomatologie, hôpital Roger-Salengro, CHU de Lille, rue Émile-Laine, 59037 Lille, France; Association internationale de médecine orale et maxillo-faciale, 7, bis rue de la Créativité, 59650 Villeneuve-d'Ascq, France; Université Lille Nord de France, UDSL, 1, rue Lefèvre, 59000 Lille, France.
authors.forename: Gwenael
authors.initials: G
authors.lastname: Raoul
mesh_terms: D000328:Adult; D002680:Chin / Q000473:pathology; D005145:Face / Q000033:anatomy & histology / Q000473:pathology*; D005149:Facial Expression; D005260:Female; D006801:Humans; D008046:Lip / Q000473:pathology; D008297:Male; D008334:Mandible / Q000473:pathology; D019186:Mandibular Advancement / Q000379:methods; D008437:Maxilla / Q000473:pathology; D008875:Middle Aged; D017060:Patient Satisfaction; D020181:Sleep Apnea, Obstructive / Q000473:pathology / Q000601:surgery*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Facial morphology; Maxillomandibular advancement surgery; Sleep apnea syndrome