Maxillomandibular Advancement & Orthognathic Surgery

Maxillomandibular advancement (MMA) remains one of the most effective surgical interventions for patients with OSA and has compared favorably to CPAP in a variety of studies. MMA involves osteotomies of the maxilla and mandible with all incisions placed in the mouth, followed by advancement that is frequently accompanied by a counterclockwise rotation. The net effect includes an increased volume for intraoral structures and stability of the airway dilator muscles.

MMA is not simply “orthognathic surgery” where jaws are moved forward. MMA is where skeletal movements are used to treat a soft tissue problem (airway). That said, we also account for the orthognathic considerations when designing MMA movements.

Beyond the AHI, MMA has shown normalization of sleep architecture (increased REM sleep and decreased wakefulness after sleep onset). It has also shown improvements in multiple health-related and functional outcomes.