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Maxillomandibular advancement as surgical treatment for obstructive sleep apnea in active duty military personnel: a retrospective cohort.

OBJECTIVE
The objective of our study is to assess the surgical outcomes of active duty military personnel undergoing maxillomandibular advancement (MMA) for the treatment of obstructive sleep apnea.


METHODS
Pre- and postoperative data on 37 military personnel who underwent MMA were assessed for changes in apnea-hypopnea index (AHI) and minimum oxygen saturation. A surgical success was defined as a reduction of AHI by 50% or a postoperative AHI of <20.


RESULTS
83.7% had an AHI greater than 20 (n = 33; range 7.6-118) with a mean preoperative AHI of 50.5 per hour. The postoperative AHI decreased by 36.3 to a new value of 14.2 (p < 0.001). Most service members experienced a postoperative AHI of less than 20 (n = 28; 76%). Sixteen (43%) had a surgical cure (AHI < 5). The number of surgical successes for this study was 81% (n = 30). The mean minimal nocturnal oxyhemoglobin saturation did not significantly change from preoperative 85% (SD = 6.8%) to postoperative 86% (SD = 7%; p = 0.21).


CONCLUSION
MMA represents a viable surgical treatment option for military personnel in whom continuous positive airway pressure is either not tolerated or for those who desire a fully deployable status.