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Maxillomandibular Advancement

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Management of Obstructive Sleep Apnea

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Abstract

Maxillomandibular advancement (MMA) is one of the most effective techniques for obstructive sleep apnea (OSA). The procedure treats the root anatomic cause of sleep-disordered breathing by correcting an inadequate airway that disrupts the vital delivery of oxygen to the brain, circulatory system, and the rest of the body. Insufficient oxygenation results in insufficient sleep, daytime sleepiness, and impaired cognitive function, as well as a range of symptoms including dry mouth and nocturia. OSA is also linked to a multitude of comorbid conditions, including metabolic syndrome, obesity, and cardiovascular disease, among others. Together with CPAP and other symptom-relieving devices, adjunct treatments, noninvasive lifestyle modifications, and other surgical interventions for OSA, MMA has demonstrated effectiveness and long-term stability. MMA represents an ostensible cure for the syndrome the first time if complications, relapse, and reoperation can be avoided. One significant challenge of MMA is balancing facial harmony while achieving improved airway patency. Counterclockwise rotation of the maxillomandibular complex has been proposed as one potential solution. Concomitant TMJ-MMA is also discussed. Diagnosis, indications, contraindications, and the treatment process itself is also described in detail from preoperative and perioperative periods through to postoperative follow-up.

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Authors and Affiliations

  1. Department of Orthodontics, Saint Louis University, St. Louis, MO, USA

    Reza Movahed

  2. Private Practice, St. Louis, MO, USA

    Reza Movahed

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  1. Orthodontics, Saint Louis University Orthodontics, Saint Louis, MO, USA

    Ki Beom Kim

  2. Orthodontics, Saint Louis University Orthodontics, Saint Louis, MO, USA

    Reza Movahed

  3. Washington University in St. Louis School of Medicine, Saint Louis, MO, USA

    Raman K. Malhotra

  4. Otolaryngology-Head and Neck Surgery, University of Michigan–Ann Arbor, Ann Arbor, MI, USA

    Jeffrey J. Stanley

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Movahed, R. (2021). Maxillomandibular Advancement. In: Kim, K.B., Movahed, R., Malhotra, R.K., Stanley, J.J. (eds) Management of Obstructive Sleep Apnea. Springer, Cham. https://doi.org/10.1007/978-3-030-54146-0_28

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