Maxillomandibular advancement surgery after long-term use of a mandibular advancement device in a post-adolescent patient with obstructive sleep apnea.
Keun-Ha LeeKyung-A KimYong-Dae KwonSung-Wan KimSu-Jung KimPublished in: Korean journal of orthodontics (2019)
Patients with obstructive sleep apnea (OSA) whose phenotype belongs to a craniofacial vulnerability are referred from sleep doctors to orthodontists. In adults, for osseo-pharyngeal reconstruction (OPR) treatment, permanent maxillomandibular advancement (MMA) surgery and use of a temporary mandibular advancement device (MAD) are applied. This case report demonstrates successful treatment of OSA through application of phased MAD and MMA in a 16-year-old male with craniofacial deformity and residual growth potential. This patient showed skeletal and dentoalveolar changes after 7-year MAD use throughout post-adolescence, which affected the design and timing of subsequent MMA surgery, as well as post-surgical orthodontic strategy. This case report suggests that OPR treatment can be useful for treatment of OSA in post-adolescent patients, from an orthodontic point of view, in close collaboration with sleep doctors for interdisciplinary diagnosis and treatment.
Keyphrases
- obstructive sleep apnea
- case report
- minimally invasive
- positive airway pressure
- coronary artery bypass
- mental health
- physical activity
- end stage renal disease
- depressive symptoms
- chronic kidney disease
- climate change
- sleep quality
- newly diagnosed
- sleep apnea
- risk assessment
- acute coronary syndrome
- combination therapy
- patient reported outcomes
- patient reported
- medical students
- peritoneal dialysis
- childhood cancer