Obstructive Sleep Apnea Syndrome is a disease that can potentially threaten the life of the patient and is characterized by apnea or hypopnea than cause upper airway obstruction during sleep.
Clinically results in altered sleep architecture, daytime sleepiness, impaired cognitive function, decreased work performance, alteration of the character, insomnia, depression or cardiovascular disease (hypertension, ischemic heart disease) or sudden death during sleep.
One of the risk factors is obesity. Weight loss is associated with clinical improvement, as well as to avoid alcohol and drugs that suppress the central nervous system.
When the Apnea-hypopnea index (HI) is> 15 events per hour or when 5-14 with clinical sequelae it is necessary to start the treatment.
In cases with mild or moderate disease it can be treated through therapy with continuous positive pressure airway (CPPA) or oral devices to protrude the mandible forward or to pull the tongue above and away from the posterior pharyngeal wall. 20-40% of patients starting treatment with CPAP do not continue due to discomfort and lack of adaptation.
Surgical treatment should be individualized according to the anatomy of the maxillofacial skeleton and soft tissues of the patient. Orthognathic surgery can move the lower facial third forward with soft tissues achieving an increase in the volume of the upper airway and reducing the closure of the airway in the naso-oropharynx during sleep.
The maxillomandibular advancement is the most effective treatment (excluding tracheostomy) for OSAS with success rates between 96 and 100% in the improvement of apnea-hypopnea index per hour. This is a very common operation in Maxillofacial Surgery for the treatment of dentofacial deformities and disorders of occlusion achieving a facial harmony, a normal occlusion and improvement in temporomandibular joint with an apparent aesthetic effect.