Soft tissue changes after maxillo-mandibular advancement in OSAS patients: a three-dimensional study

J Craniomaxillofac Surg. 2014 Jan;42(1):66-72. doi: 10.1016/j.jcms.2013.02.004. Epub 2013 Mar 19.

Abstract

Introduction: Maxillo-mandibular advancement (MMA) is the most successful surgical treatment for OSAS. This study prospectively evaluated soft tissue changes in typical OSAS patient before and after MMA.

Material and methods: Ten patients with severe OSAS, who underwent MMA, were considered. Age, BMI, polysomnographic recordings and cephalometric data were examined. Facial surface data acquired using a 3D laser scanner before (T0) and 1 year (T1) after surgery were pooled by electronic surface averaging to obtain the mean T0 and T1 facial model. A virtual optimal face (V) was used as control group. Mean T0, T1 and V models were compared.

Results: The mean AHI improved from 69.8 ± 35.2 to 17.3 ± 16.7. The mean maxillary advancement was 9.2 mm ± 1.2 and the mean mandibular advancement was 10.4 mm ± 2.2. The comparison between T0 and T1 showed an overall increase of the sagittal projection of the cheeks, lips and of the chin. The comparison between T1 and V showed a transversal increase of the cheeks at the cross section through ch (cheilon).

Conclusion: MMA is a highly effective treatment for OSAS. The evaluations of 3D laser scanning showed that surgery in OSAS patients didn't cause an impairment of the facial appearance.

Keywords: Maxillo-mandibular advancement; Obstructive sleep apnoea syndrome; Soft tissue; Three-dimensional surface laser scanner.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Age Factors
  • Body Mass Index
  • Cephalometry / methods
  • Cheek / anatomy & histology
  • Chin / anatomy & histology
  • Face / anatomy & histology*
  • Follow-Up Studies
  • Holography / methods
  • Humans
  • Image Processing, Computer-Assisted / methods
  • Imaging, Three-Dimensional / methods
  • Lasers
  • Lip / anatomy & histology
  • Male
  • Mandibular Advancement / methods*
  • Maxilla / surgery*
  • Middle Aged
  • Osteotomy, Le Fort / methods
  • Osteotomy, Sagittal Split Ramus / methods
  • Patient Satisfaction
  • Polysomnography / methods
  • Prospective Studies
  • Sleep Apnea, Obstructive / surgery*
  • User-Computer Interface