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  1. Fulltext How does mandibular advancement with or without maxillary procedures affect pharyngeal airways? An overview of systematic reviews
    Tan SK, Leung WK, Tang ATH, Zwahlen RA
    PLoS One, 2017;12(7):e0181146.
    PMID: 28749983 DOI: 10.1371/journal.pone.0181146
    BACKGROUND: Mandibular advancement surgery may positively affect pharyngeal airways and therefore potentially beneficial to obstructive sleep apnea (OSA).

    OBJECTIVE: To collect evidence from published systematic reviews that have evaluated pharyngeal airway changes related to mandibular advancement with or without maxillary procedures.

    METHODOLOGY: PubMed, EMBASE, Web of Science, and Cochrane Library were searched without limiting language or timeline. Eligible systematic reviews evaluating changes in pharyngeal airway dimensions and respiratory parameters after mandibular advancement with or without maxillary surgery were identified and included.

    RESULTS: This overview has included eleven systematic reviews. Maxillomandibular advancement (MMA) increases linear, cross-sectional plane and volumetric measurements of pharyngeal airways significantly (p<0.0001), while reducing the apnea-hypopnea index (AHI) and the respiratory disturbance index (RDI) significantly (p<0.0001). Two systematic reviews included primary studies that have evaluated single-jaw mandibular advancement, but did not discuss their effect onto pharyngeal airways. Based on the included primary studies of those systematic reviews, single-jaw mandibular advancement was reported to significantly increase pharyngeal airway dimensions (p<0.05); however, conclusive long-term results were lacking.

    CONCLUSION: MMA increases pharyngeal airway dimensions and is beneficial to patients suffering from OSA. However, more evidence is still needed to draw definite conclusion related to the effect of single-jaw mandibular advancement osteotomies on pharyngeal airways.

    Matched MeSH terms: Mandibular Advancement/methods*
  2. Fulltext Mandibular advancement by distraction Osteogenesis for obstructive sleep apnea in patient with Pierre Robin Sequence: a case report
    Mohamed Hisham Mohamed Jali @ Yunos, Shaifulizan Abdul Rahman, Ramizu Shaari
    International Medical Journal Malaysia, 2017;16(21):28-28.
    MyJurnal
    Pierre Robin Sequence (PRS) is a condition consists of set of anomalies, which are
    cleft palate, micrognathia and glossoptopsis. Management of patients with PRS addresses two main
    problems, namely airway obstruction and feeding difficulties. Airway obstruction may lead to
    obstructive sleep apnea (OSA). Treatment modalities for OSA are based on the causes. There are
    surgical and non-surgical methods. Non-surgical methods such as diet, medication, oral appliances
    and continuous positive airway pressure (CPAP) can only be employed in moderate cases. Surgical
    method such as maxillo-mandibular advancement or expansion can be achieved by orthognathic
    surgery or distraction osteogenesis. (Copied from article).
    Matched MeSH terms: Mandibular Advancement
  3. Temporomandibular Joint Ankylosis Leading to Obstructive Sleep Apnea
    Shaeran TAT, Samsudin AR
    J Craniofac Surg, 2019 Jun 28.
    PMID: 31261319 DOI: 10.1097/SCS.0000000000005689
    Temporomandibular joint ankylosis in children commonly lead to difficulty in feeding, poor oral hygiene, retrognathic mandible and obstructive sleep apnea. Surgical release of the ankylosis has always been the standard treatment. The authors report a 12 year old boy with unilateral temporomandibular joint ankylosis and obstructive sleep apnea underwent surgical release of the ankylosis with successful gain in mouth opening. However, he continued to suffer from obstructive sleep apnea as confirmed by post-operative polysomnography. Orthognathic surgery for mandibular advancement is not favorable due to his young age and mandibular distraction osteogenesis was not a choice. A mandibular advancement device similar to orthodontic myofunctional appliance was the preferred choice in the post-operative period while waiting for definitive retrognathia surgical treatment after skeletal maturity. Surgical release of temporomandibular joint ankylosis corrects the oral problem but does not adequately address the narrow pharyngeal airway space. Assessment of pharyngeal airway with a high suspicion of obstructive sleep apnea is mandatory in the management of TMJ ankylosis.
    Matched MeSH terms: Mandibular Advancement
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