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Complications Associated with Maxillomandibular Advancement

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Management of Obstructive Sleep Apnea

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Abstract

Maxillomandibular advancement is one of the most effective techniques used to treat obstructive sleep apnea. The procedure, however, is not without risk. While serious complications appear to be very rare in orthognathic surgery, there have been various reports of potentially serious, even fatal conditions arising during or after the procedure due to spontaneous pneumomediastinum, pneumothorax, pseudoaneurysm, excessive intraoperative bleeding and delayed secondary hemorrhage, obstructed airway due to swelling, and adverse responses to anesthesia. Complications are rarely fatal. In comparison to these very rare major adverse events, others are slightly more frequent complications, including bad splits, bone necrosis, condylar resorption or malposition, or other temporomandibular joint issues, infections, nerve damage, impaired vision or hearing, or neuropsychiatric challenges, among others. Patient populations at risk for complications and treatment failure include the obese and/or large neck circumference, advanced age, adolescents and young adults, as well as patients with several comorbidities and polypharmacy. Effective communication of the risks of surgery is essential so the patient can make an informed decision led by a surgeon knowledgeable of the wide range of risks and alternatives to provide safe care throughout the treatment continuum.

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Acknowledgments

The authors would like to acknowledge their gratitude for the expertise and skill of the many mentors who painstakingly taught and guided them through their respective residencies and fellowships.

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Authors and Affiliations

  1. Department of Orthodontics, Saint Louis University, St. Louis, MO, USA

    Reza Movahed

  2. Private Practice, St. Louis, MO, USA

    Reza Movahed

  3. Department of Oral and Maxillofacial Surgery, William Beaumont Army Medical Center, El Paso, TX, USA

    Joseph W. Ivory & Frank Delatour

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  1. Orthodontics, Saint Louis University Orthodontics, Saint Louis, MO, USA

    Ki Beom Kim

  2. Orthodontics, Saint Louis University Orthodontics, Saint Louis, MO, USA

    Reza Movahed

  3. Washington University in St. Louis School of Medicine, Saint Louis, MO, USA

    Raman K. Malhotra

  4. Otolaryngology-Head and Neck Surgery, University of Michigan–Ann Arbor, Ann Arbor, MI, USA

    Jeffrey J. Stanley

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Movahed, R., Ivory, J.W., Delatour, F. (2021). Complications Associated with Maxillomandibular Advancement. In: Kim, K.B., Movahed, R., Malhotra, R.K., Stanley, J.J. (eds) Management of Obstructive Sleep Apnea. Springer, Cham. https://doi.org/10.1007/978-3-030-54146-0_32

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