Maxillomandibular Advancement Using Total Joint Replacement for the Treatment of Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder in the USA that predisposes patients to multisystemic health complications. Typically, patients have nocturnal airway collapse and disruption of sleep due to redundant tissue or a retrognathic mandible; however, some patients develop OSA due to severe, destructive end-stage temporomandibular joint (TMJ) disease. The subsequent loss of vertical height and mandibular projection results in posterior oropharyngeal airway collapse that can cause or exacerbate OSA. This chapter discusses the preoperative evaluation, treatment planning, indications, as well as the surgical technique used to treat a patient undergoing MMA using a TJP, and a maxillary osteotomy as the treatment for OSA.