Case Report: Treating obstructive sleep apnea with maxillomandibular advancement surgery in a case with a previously reconstructed mandible.

Abstract

<h4>Background</h4>Maxillomandibular advancement (MMA) serves as a surgical option for the management of obstructive sleep apnea (OSA). However, its application in patients with a previously reconstructed mandible is rarely reported and technically challenging. This paper reports a case of MMA for OSA in a patient who had undergone mandibular reconstruction.<h4>Clinical presentation</h4>A 53-year-old male, who previously received mandibular reconstruction with a fibula flap, underwent MMA for severe OSA [apnea hypopnea index (AHI) = 35.2]. Virtual surgical planning with patient-specific guides and osteosynthesis plates were used to enable precise maxillary and mandibular advancement. Post-surgery, AHI decreased to 17.6, markedly improving daytime sleepiness. Complications were minimal, limited to transient paraesthesia and osteosynthesis material removal.<h4>Conclusion</h4>This case suggests that, when carefully planned and executed, MMA using patient-specific osteotomy guides and osteosynthesis plates can be a feasible, effective, and surgically safe treatment option for OSA in selected patients with a previously reconstructed mandible.