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Sleep Issues
Surgery to Move Both Jaws Forward Noticeably Improves Obstructive Sleep Apnea
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Aug 1, 2013 - 5:52:23 PM

(HealthNewsDigest.com) - ROSEMONT, Ill., Aug. 1, 2013 -- Maxillomandibular advancement (MMA), a surgical procedure performed by oral and maxillofacial surgeons to move both the upper and/or lower jaws forward, has been shown to noticeably improve obstructive sleep apnea (OSA), according to Computational Fluid Dynamic Analysis of the Posterior Airway Space After Maxillomandibular Advancement for Obstructive Sleep Apnea Syndrome, an article published in the August 2013 issue of the Journal of Oral and Maxillofacial Surgery.  This works is of importance to many patients suffering the dangerous and often life-threatening signs of airway obstruction during sleep, a condition being more and more frequently diagnosed in the US.

To evaluate the outcomes of MMA for patients with OSA, researchers led by Somsak Sittitavornwong, DDS, DMD, MS, and Peter D. Waite, MPH, DDS, MD, at the University of Alabama at Birmingham, selected and studied eight patients diagnosed with mild to severe OSA who had undergone maxillomandibular advancement surgery. All study participants underwent pre-and postoperative computed tomography to establish upper airway computed tomographic datasets with 3-dimensional models to study how the surgical changes in airway structure affected the pressure effort required for normal breathing. By comparing the pre- and postoperative airway dimensions, skeletal changes, apnea-hypopnea index, and pressure effort of the 3-dimensional models, the researchers were able to interpret the surgical results.

Significantly, they found that by surgically increasing the distance from the occipital base, or back of the skull, to the pogonion, or forward point on the chin, MMA significantly increased patients' airway dimensions. This increase reflects an improvement in the apnea-hypopnea index used to gauge the severity of OSA, and a decreased pressure effort of the upper airway, a factor that decreases the patient's needed effort to breathe. As a result of this study, the researchers determined that MMA substantially improves the condition of obstructive sleep apnea.

Read the complete study findings at J Oral Maxillofac Surg. 2013;71:1397.
http://dx.doi.org/10.1016/j.joms.2013.02.022

The Journal of Oral and Maxillofacial Surgery is published monthly by the American Association of Oral and Maxillofacial Surgeons to present to the dental and medical communities comprehensive coverage of new techniques, important developments and innovative ideas in oral and maxillofacial surgery. Practice-applicable articles help develop the methods used to handle dentoalveolar surgery, facial injuries and deformities, TMJ disorders, oral cancer, jaw reconstruction, anesthesia and analgesia. The journal also includes specifics on new instruments and diagnostic equipment and modern therapeutic drugs and devices.

Web Site: http://www.aaoms.org
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