Complications/adverse effects of maxillomandibular advancement for the treatment of OSA in regard to outcome

Abstract

Objective: To evaluate adverse effects/postoperative complications and surgical response rate of maxillomandibular advancement for the treatment of severe obstructive sleep apnea syndrome. Study Design: Case series with chart review. Setting: Otolaryngology Head and Neck Surgery Department in a teaching hospital. Subjects and Methods: A total of 59 consecutive severe sleep apnea patients underwent maxillomandibular advancement. Systemic complications were evaluated from medical charts. Functional adverse effects and cosmetic consequences were evaluated by questionnaires. The treatment outcome was assessed by polysomnography. Results: Fifty patients were evaluated. They had a mean age of 46.4 ± 9.0 years. No serious postoperative complication was observed. The most frequent local complication was mental nerve sensory loss. Most patients reported cosmetic changes. The mean apnea-hypopnea index decreased from 65.5 ± 26.7 per hour to 14.4 ± 14.5 per hour ( P < 0.0001). Light-sleep stages were also decreased ( P < 0.0001), whereas deep-sleep stages were increased ( P < 0.001). Conclusion: Maxillomandibular advancement can induce local adverse effects and cosmetic changes, but they seem to be considered as secondary to the patients according to the surgical outcome.