Maxillomandibular Advancement Surgery

hotsiagoodman
November 9, 2024
The Stop Snoring And Sleep Apnea Program™ By Christian Goodman The Stop Snoring and Sleep Apnea Program is a well-researched program created to help stop snoring and sleep apnea so that you can have a good night sleep. The techniques that you will learn from this program works immediately. It will only take you 3-7 minutes to perform these simple exercises that the author has recommended but the results that you will get will help you have a good night sleep as soon as tonight. Within a week, snoring will be a thing of the past.

Maxillomandibular Advancement Surgery

Maxillomandibular advancement surgery (MMA) is a surgical treatment for obstructive sleep apnea (OSA), particularly in cases where CPAP therapy or other conservative treatments have not been effective. MMA involves repositioning the upper jaw (maxilla) and the lower jaw (mandible) forward to enlarge the upper airway and improve airflow, thus reducing or eliminating the airway obstructions that occur during sleep.

What is Maxillomandibular Advancement Surgery?

MMA is a type of orthognathic surgery that addresses sleep apnea by repositioning the bones of the upper and lower jaws to create more space for the airway. This surgery is most often used for people with severe obstructive sleep apnea (OSA), particularly when the obstruction is caused by anatomical factors such as a recessed jaw, narrow airway, or skeletal malformations that cause the airway to collapse during sleep.

The surgery is typically considered when other treatments, such as CPAP therapy, oral appliances, or lifestyle changes, have not been successful.

How MMA Works for Sleep Apnea:

  1. Surgical Procedure:
    • The surgeon makes cuts in the bones of the upper and lower jaws and repositions them forward. This shifts the jaw structure, which creates more space in the airway, particularly in the area behind the tongue and soft palate.
    • The repositioned bones are then secured with plates and screws to hold them in place as they heal.
  2. Airway Enlargement: By bringing the upper and lower jaws forward, MMA enlarges the upper airway, particularly the pharyngeal space, which is where airway collapse often occurs in obstructive sleep apnea. This forward repositioning of the jaw prevents or reduces the airway blockages that contribute to apneas (breathing pauses) during sleep.
  3. Improved Breathing: With a wider and less obstructed airway, patients can breathe more easily during sleep, leading to fewer apnea episodes and reduced snoring. The surgery can dramatically improve overall sleep quality, reducing daytime sleepiness and improving cognitive function.

Candidates for Maxillomandibular Advancement:

MMA is typically recommended for patients with severe obstructive sleep apnea who have not had success with other treatments, such as CPAP. Good candidates for MMA may include individuals who:

  • Have severe OSA and have failed or cannot tolerate CPAP therapy.
  • Have an anatomical abnormality of the jaw or airway that contributes to airway collapse.
  • Have recessed jaws or jaw misalignment, which can narrow the airway.
  • Are non-obese (though it can sometimes be used in obese individuals with specific anatomical issues).
  • Are healthy enough to undergo surgery and anesthesia.

Benefits of Maxillomandibular Advancement Surgery:

  1. Improved Airway Patency: The primary benefit of MMA is the creation of a wider airway, which reduces or eliminates airway obstruction and apneas during sleep. This can dramatically improve breathing and reduce snoring.
  2. Effective for Severe Cases: MMA is one of the most effective treatments for severe obstructive sleep apnea and can be a life-changing solution for patients who have not found relief from other therapies like CPAP.
  3. Potential for Long-Term Relief: Unlike CPAP, which requires ongoing use, MMA can provide permanent relief from sleep apnea, as it directly addresses the anatomical causes of the condition.
  4. Improved Sleep Quality: With fewer apnea events, patients often experience better sleep quality, reduced daytime sleepiness, and improved cognitive function.
  5. Better Quality of Life: Many patients report improvements in mood, memory, and overall well-being after MMA, as they no longer suffer from the cognitive and physical effects of untreated sleep apnea.
  6. Reduction in Cardiovascular Risk: Untreated OSA is associated with a variety of cardiovascular risks, including high blood pressure, heart disease, and stroke. By resolving the apneas, MMA can reduce the long-term health risks associated with sleep apnea.

How is Maxillomandibular Advancement Performed?

  1. Pre-Operative Planning:
    • Before surgery, the patient undergoes a thorough evaluation that includes imaging studies such as X-rays or CT scans to assess the anatomy of the jaw and airway. The surgeon may also perform a sleep study (polysomnography) to assess the severity of the sleep apnea.
    • The surgical plan is customized based on the patient’s specific anatomy and needs.
  2. Surgical Procedure:
    • MMA is usually performed under general anesthesia and can take between 2-4 hours.
    • The surgeon will make cuts in the bones of the upper and lower jaws. The maxilla (upper jaw) is moved forward, and the mandible (lower jaw) is also advanced forward to create more space in the airway.
    • Plates and screws are used to secure the bones in their new position.
  3. Post-Operative Care:
    • Patients typically stay in the hospital for 1-2 days after surgery for monitoring and pain management.
    • After the procedure, the patient may experience swelling, bruising, and some discomfort in the jaw and mouth. These effects typically resolve in a few weeks.
    • Pain management is provided, and the patient may need to follow a soft food diet for several weeks.
    • Patients are generally advised to avoid strenuous activity for a few weeks during recovery.
  4. Healing Time:
    • The initial recovery period typically lasts about 6-8 weeks, but complete healing of the jaw bones can take several months.
    • A follow-up visit with the surgeon is necessary to monitor healing and make adjustments if needed.

Risks and Potential Complications of MMA:

As with any major surgery, MMA carries some risks:

  1. Pain and Discomfort: While pain is generally manageable with medication, some discomfort is common during the recovery process.
  2. Swelling and Bruising: Significant swelling and bruising around the face and jaw are typical following MMA. These side effects usually subside within a few weeks.
  3. Infection: As with any surgery, there is a risk of infection at the surgical site.
  4. Bleeding: Although rare, excessive bleeding can occur during or after the surgery.
  5. Jaw Issues: Some patients may experience changes in their bite, or malocclusion (misalignment of the teeth), which may require orthodontic treatment after surgery.
  6. Nerve Damage: There is a small risk of damage to the nerves in the jaw, which can lead to temporary or, in rare cases, permanent numbness or tingling in the chin or lips.
  7. Failure to Resolve Sleep Apnea: While MMA is highly effective, it may not completely resolve sleep apnea in every patient. In some cases, additional treatments such as CPAP may still be required.

Recovery After Maxillomandibular Advancement:

  1. Pain Management: Patients are typically prescribed pain relievers and may need ice packs to reduce swelling.
  2. Dietary Restrictions: A soft food diet is recommended for the first few weeks to avoid putting stress on the jaw while it heals.
  3. Follow-Up Visits: Regular follow-up visits with the surgeon are necessary to monitor the healing process and make sure the jaw is healing properly.
  4. Physical Activity Restrictions: Strenuous physical activities, including exercise, should be avoided for several weeks to ensure proper healing.
  5. Orthodontic Treatment: Some patients may require orthodontic treatment to help align their teeth after surgery, especially if their bite is affected.

Success Rates of MMA for Sleep Apnea:

Maxillomandibular advancement is one of the most effective surgical treatments for severe obstructive sleep apnea. Studies show that 80-90% of patients experience significant improvement in their sleep apnea symptoms, including:

  • Decreased apneas and hypopneas (breathing pauses).
  • Reduced snoring.
  • Improved oxygen saturation levels during sleep.
  • Improved daytime energy and reduced sleepiness.

Conclusion:

Maxillomandibular advancement surgery is a highly effective treatment for severe obstructive sleep apnea in individuals whose condition is caused by anatomical factors such as a recessed or misaligned jaw. By repositioning the upper and lower jaws, MMA enlarges the airway and significantly reduces or eliminates the obstructions that cause sleep apnea. While the surgery carries risks and requires a significant recovery period, it can provide long-term, permanent relief for patients who have not had success with other treatments like CPAP.


The Stop Snoring And Sleep Apnea Program™ By Christian Goodman The Stop Snoring and Sleep Apnea Program is a well-researched program created to help stop snoring and sleep apnea so that you can have a good night sleep. The techniques that you will learn from this program works immediately. It will only take you 3-7 minutes to perform these simple exercises that the author has recommended but the results that you will get will help you have a go