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Laryngoscope. 2003 Sep;113(9):1577-82.

Modified maxillomandibular advancement for the treatment of obstructive sleep apnea: a preliminary report.

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Department of Otolaryngology, Singapore General Hospital.



A prospective study to evaluate the modified maxillomandibular advancement (MMA) technique for the treatment of obstructive sleep apnea (OSA).


Eleven patients underwent modified MMA for the treatment of OSA. All the patients underwent presurgical and postsurgical polysomnography, nasolaryngoscopy, and clinical facial photographic assessment. The results were analyzed after a minimum of 6 months postsurgery (mean, 7.7 months).


The preoperative polysomnography results were as follows: apnea index, 55.7 +/- 19.8; apnea-hypopnea index, 70.7 +/- 15.9; lowest oxygen saturation, 58.6 +/- 12.3%; longest apnea/hypopnea, 67.9 +/- 23.7 seconds; and arousal index, 47.1 +/- 18.2. The postoperative polysomnography results were as follows: apnea index, 3.4 +/- 3.4; apnea/hypopnea index, 11.4 +/- 7.4; lowest oxygen saturation, 83.9 +/- 8.8%; longest apnea/hypopnea, 38.2 +/- 24.6 seconds; and arousal index, 15.1 +/- 7.3. The mean postoperative body mass index (BMI) was 27.2 +/- 3.3. The mean BMI change after surgery was 6.5%.


The preliminary review has demonstrated that the modified MMA technique for the treatment of OSA is highly effective in the treatment of severe OSA without the significant facial profile change commonly associated with the traditional MMA technique.

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