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Sleep Surgeon Question 20

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Question 20 - Questions regarding healing from MMA.

From: B. R.

I have a question for you regarding healing from MMA. A friend of mine recently had an MMA done, he did not need a huge amount of advancement on top so he had a pretty straight forward Lefort 1 and was only advanced 5mm forward.

He is 8 weeks post op and noticed that his maxilla was feeling quite loose. When he went to see his surgeon he told him that he has a maxillary "fibrous union" or "delayed union," We cannot find any info on this condition.

Can you tell me what could cause this or how this would happen? Is this a common thing? Also, what is the treatment for this? Will he have to have more surgery to fix it?

Thank you so much for your reply!

Answer Provided by Dr. Kasey Li
August 29, 2007

Fibrous union after an osteotomy is very uncommon. The potential causes are that there is insufficient amount of bony contacts or excessive amount of movement of the jaw causing mobility at the osteotomy site.

I would first recommend no chewing for a few weeks to minimize the amount of stress placed on the jaw to see if it “firms” up. There is a good chance that it will. The worst case would be an operation with bone grafting and rigid fixation to stabilize the maxilla.

Good luck.

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