Abstract
Segmental mandibular advancement (SMA) consists of a combination of bilateral sagittal
split osteotomy, anterior subapical osteotomy with extraction of the first premolars,
and genioplasty, to allow an extended advancement of the mandible for the improvement
of tongue base obstruction in moderate-to-severe obstructive sleep apnoea (OSA) and
to minimize any unfavourable aesthetic change due to the large jaw advancement. The
aim of this pilot study was to evaluate the surgical outcomes and complications following
SMA in OSA patients. Twelve patients (nine male, three female) underwent SMA as part
or whole of their skeletal advancement procedure for OSA. The apnoea–hypopnoea index
(AHI) improved from a mean± standard deviation 42.4 ± 22.0/hour preoperatively to
9.0 ± 17.4/hour at 1 year postoperative. Surgical success (50% reduction in AHI) was
achieved in 11 of the 12 patients (91.7%) at 1 year postoperative, while seven patients
(58.3%) attained surgical cure (AHI<5/hour). The lowest oxygen saturation (LSAT) increased
from a mean 73.3% preoperatively to 78.7% at 1 year postoperative. The airway volume
increased from a mean 2.4 ± 1.7 cm3 at baseline to 6.7 ± 3.5 cm3 at 1 year postoperative (P < 0.001). No major complication occurred. This pilot study showed that SMA appears
to be safe and effective as part or whole of the skeletal advancement surgery for
moderate-to-severe OSA.
Keywords
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Article info
Publication history
Published online: November 29, 2022
Accepted:
November 3,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
