Treatment of severe cases of adult obstructive sleep apnea Syndrome is a life-long process. Consisting of every-night wear of a continuous pressure ventilation mask or the use of an oral appliance, side effects can appear a constraint and lead to progressive abandon of treatment.
Maxillo-mandibular advancement surgery allows a global and stable treatment of pharyngeal collapsus. Patient selection for this surgical procedure is difficult; a multidisciplinary team approach is mandatory, gathering a sleep physician, an orthodontist and surgeon. Occlusal analysis is associated with a cephalometric study, to look for skeletal abnormalities that could favour obstruction of the pharynx; the chosen protocol then aims at simultaneous treatment of apneic events and orthognathic abnormalities.