Orthognathic surgery planning in the complex treatment of the patients with obstructive sleep apnea. Part II

Abstract

MMA is the most effective surgical technique in the treatment of obstructive sleep apnea (OSA) for adult patients and gives way only tracheostomy treatment. However, despite the advantages, MMA is currently not widely used in the treatment of this pathology in the Russian Federation due to complexity, invasiveness and duration. The success of complex surgical treatment directly depends on the team approach and qualified specialists. The purpose of this publication is to popularize MMA among medical specialists involved in the treatment of OSA. Materials and methods. The authors evaluated the dynamics of the clinical and laboratory data (polysomnography, cone-beam computed tomography, articulated dental cast analysis) in patient with OSA and MMA treatment before and after 3 years post complex rehabilitation. Results. The results of the complex treatment: elimination of OSA, reduction in the snoring intensity, normalization of sleep quality, level of mean oxygen saturation, the position of the jaws and aesthetic proportions of the face, increase respiratory volume and lumen in the pharynx, establishing occlusion according to Angle class I, lack of dysfunction and pathological remodeling of the TMJ. Conclusion. The planning of the MMA with the use of cephalometric analysis considering changes in the soft tissues improved a lot the aesthetic proportions of the patient’s face. After long and complex treatment during 36 months, the elimination of the upper airway obstruction zones was achieved while maintaining and / or improving the normal function of the structures of the middle and lower zones of the face associated with them.