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Residual POSA After Maxillomandibular Advancement in Patients with Severe OSA

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Positional Therapy in Obstructive Sleep Apnea

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Abstract

In patients with severe or extreme OSA and CPAP failure, maxillomandibular advancement (MMA) can be considered. Because of its considerable morbidity, MMA is mostly reserved for severe to extreme cases, often after less aggressive surgeries have failed. The success rates of MMA are very high: between 80 and 90 %. A new finding is that MMA failure can be due to the fact that after surgery the AHI in supine sleep position remains much higher as compared to the non-supine AHI: in other words, non-positional OSA has reversed into less severe POSA. Postoperative residual POSA can be in theory a good indication for additional positional therapy. In this chapter we will discuss our theoretical considerations on this phenomenon of residual POSA after MMA surgery.

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Author information

Authors and Affiliations

  1. Ear Nose and Throat, Sint Lucas Andreas Ziekenhuis, Jan Tooropstraat 164, 1061 AE, Amsterdam, The Netherlands

    Linda B. L. Benoist M.D.

  2. Department of Oral and Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    Maurits H. T. de Ruiter D.D.S. & Jan de Lange D.M.D., M.D., Ph.D.

  3. Department of Otolaryngology, Sint Lucas Andreas Ziekenhuis, Amsterdam, The Netherlands

    Nico de Vries M.D., Ph.D.

  4. Department of Otolaryngology, University Hospital Antwerp, Antwerp, Belgium

    Nico de Vries M.D., Ph.D.

Authors
  1. Linda B. L. Benoist M.D.
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  2. Maurits H. T. de Ruiter D.D.S.
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  3. Jan de Lange D.M.D., M.D., Ph.D.
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  4. Nico de Vries M.D., Ph.D.
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Corresponding author

Correspondence to Linda B. L. Benoist M.D. .

Editor information

Editors and Affiliations

  1. Department of Otolaryngology, Sint Lucas Andreas Ziekenhuis, Amsterdam, The Netherlands

    Nico de Vries

  2. Department of Otorhinolaryngology, Sint Lucas Andreas Ziekenhuis, Amsterdam, The Netherlands

    Madeline Ravesloot

  3. Department of Otolaryngology, Sint Lucas Andreas Ziekenhuis, Amsterdam, The Netherlands

    J. Peter van Maanen

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Benoist, L.B.L., de Ruiter, M.H.T., de Lange, J., de Vries, N. (2015). Residual POSA After Maxillomandibular Advancement in Patients with Severe OSA. In: de Vries, N., Ravesloot, M., van Maanen, J. (eds) Positional Therapy in Obstructive Sleep Apnea. Springer, Cham. https://doi.org/10.1007/978-3-319-09626-1_29

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  • DOI: https://doi.org/10.1007/978-3-319-09626-1_29

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-09625-4

  • Online ISBN: 978-3-319-09626-1

  • eBook Packages: MedicineMedicine (R0)

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