The correlation of maxillomandibular advancement and airway volume change in obstructive sleep apnea using cone beam computed tomography

Abstract

The purpose of this retrospective study was to evaluate the correlation of maxillomandibular advancement (MMA) and airway volume changes in patients with obstructive sleep apnea (OSA), and to determine the surgical skeletal movements necessary to achieve an increase in total airway volume (TAV) of ≥70%. Thirty patients with OSA treated by MMA were evaluated. Pre- and postoperative cone beam computed tomography images were used to determine the horizontal distance and angular changes in surgical parameters and linear, area, and volumetric airway parameters. Postoperatively, the horizontal distance of surgical parameters (A-point, UI, B-point, pogonion, and menton) and craniofacial angulation (SNA and SNB) increased significantly, similar to total surface area, TAV, and minimum cross-sectional area of the airway (p<0.0001). The total airway length decreased significantly (p<0.0001). The mean increase in TAV was 67.2%. There were positive correlations between linear surgical changes and the percentage change in TAV. All surgical parameters were predictive of a change in TAV ≥70%. The optimal surgical change was 6mm for A-point, 7.9mm for UI, 7.6mm for B-point, 11.2mm for pogonion, and 10mm for menton. In conclusion, maxillary advancement of less than 10mm was adequate in this study to obtain an increase in the TAV of at least 70%.