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Int J Oral Maxillofac Surg. 2019 Mar;48(3):332-340. doi: 10.1016/j.ijom.2018.08.013. Epub 2018 Oct 19.

Long-term quality of life outcomes of maxillomandibular advancement osteotomy in patients with obstructive sleep apnoea syndrome.

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Division of Maxillofacial Surgery, Department of Surgery, AZ Sint-Jan Brugge-Oostende AV, Bruges, Belgium. Electronic address:
Division of Maxillofacial Surgery, Department of Surgery, AZ Sint-Jan Brugge-Oostende AV, Bruges, Belgium.
Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium.
Sleep Medicine Centre, Kempenhaeghe, Heeze, The Netherlands; Department of Internal Medicine, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.


This study was performed to evaluate the long-term impact of maxillomandibular advancement (MMA) surgery on the apnoea-hypopnoea index (AHI) and quality of life (QoL) in patients with obstructive sleep apnoea syndrome (OSAS). The medical files of 12 OSAS patients who underwent MMA by one surgeon between 1995 and 1999 were reviewed retrospectively. Patients received a clinical assessment, polysomnography, and QoL questionnaires as part of routine care preoperatively (n=12), within 2 years postoperative (n=12), and again in 2016 (n=9). A successful surgical outcome was defined as an AHI decrease of >50% with <20 events/h. Of the 66.7% (8/12) of patients who were initially cured, 66.7% (4/6) remained stable at a median follow-up of 19 years. Only the two patients with the highest AHI showed abnormal Epworth Sleepiness Scale scores. After convalescence, most patients reported stable symptomatic improvement. Aesthetic changes were found acceptable and all but one patient stated that they would undergo the surgery again. It is concluded that MMA is a safe and effective procedure. Ageing and weight gain might counterbalance the positive effects of surgery in the long term. It is therefore suggested that re-evaluation every 5 years should be scheduled, since a spontaneous AHI increase over time does not seem to be reflected by symptomatic changes.


apnoea–hypopnoea index; long-term; maxillomandibular advancement osteotomy; obstructive sleep apnoea syndrome; quality of life


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