Maxillomandibular advancement for obstructive sleep apnea syndrome

Maxillomandibular advancement enlarges the entire pharynx by pulling anteriorly the bony squelettal structures. It is performed in sleep apnea patients who refuse or fail to use continuous positive airway pressure. It is constantly associated to esthetic modifications but not necessarily disgraceful. Perioperative breathing complications can occur which implies a good cooperation between the surgeon and the anesthesiologists in the operating room and in the following hours in the ICU. Hypoesthesia of the lower lip and chin is the most frequent long term complication. Nevertheless, bimaxillary advancement is one of the most effective treatments for OSAS even on a long term basis.