Why Maxillomandibular Advancement Surgery May Be for You?
Did you know Obstructive Sleep Apnea (OSA) affects more than 8 million men and 4 million women in the US? Yes: and it’s twice as common in men as in women. Characterized by repeated episodes of upper airways collapsing during sleep, this condition causes the sufferer to stop breathing on and off many times during sleep, sometimes for a minute or longer. “Apnea” is Greek for “without breath.” Repeated episodes of sleep apnea can lead to daytime fatigue, and put you at risk for heart attack, stroke, high blood pressure and even death.
There are different levels of OSA, each with an ideal treatment. For mild OSA, sometimes a CPAP (continuous positive airway pressure) is all you’ll need. But for those with a more severe case, a surgical procedure known as maxillomandibular advancement (MMA) has proven to benefit the patient, according to a study published online by JAMA Otolaryngology-Head & Neck Surgery.
Maxillomandibular advancement surgery is an invasive yet often highly effective surgical procedure for the treatment of OSA, especially for those who have difficulty with the CPAP. In this procedure, the surgeon moves the upper (maxilla) and lower (mandible) jaws forward in order to enlarge the airway in both the palate and tongue regions. Compared to other single procedures, this one has been known to provide the greatest improvement in treating OSA. Still to help shape the patients’ selections and to counsel patients regarding their chances of achieving a significant improvement with MMA, an assessment of preoperative factors associated with postoperative outcomes should be considered case-by-case.
Soroush Zaghi, MD, of the David Geffen School of Medicine at the University of California, Los Angeles, and colleagues conducted a thorough post-analysis of 45 studies with individual data for 518 patients/interventions. In the studies patients had undergone MMA as treatment for OSA. Among them 74 % had undergone prior surgery for OSA. The researchers analyzed three key indicators for OSA severity: the apnea-hypopnea index (AHI), respiratory disturbance index (RDI), and measures of the severity of OSA after MMA.
They found that MMA is associated with substantial improvements to AHI and RDI. They further found that those with less severe measures of OSA experienced a smaller magnitude of change in AHI or RDI postoperatively, but they had the highest chance of achieving a surgical success and/or cure. The average reduction for AHI and RDI outcomes was 80 percent and 65 percent, respectively. Patients with high residual RDI and AHI scores (despite prior surgical procedures) were highly likely to benefit from management of OSA by means of MMA.
“Maxillomandibular advancement surgery is a highly effective treatment for OSA,” the researchers write. “Those patients with the most severe measures of OSA tend to benefit to the greatest degree.” Future studies will provide further telling insights about how this procedure may help optimize patients living with obstructive sleep apnea.
Of course, there are caveats with every invasive surgical procedure, and because of this, patients need to have direct, sensible, and honest conversations with their doctors. If you suffer from mild to severe OSA and want to know what options are available to help–even cure in some cases–your condition, perhaps you should talk to an experienced ENT specialist who understands the risks and benefits of maxillomandibular advancement surgery.