Comments on MMA
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Comments on MMA

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Posted by sleepsurgeon on March 20, 2009 at 08:39:59:

MMA is the most successful operation to treat OSA (other than tracheotomy). I will make a few comments about MMA based on my knowledge and experience of evaluating results of over 600 MMA done specifically for OSA, as well as following some patients long-term (over 12 years). First, although it is highly successful, it does not guarantee success. If one reads my past posts, one should realize that OSA can not be "cured", but can be significantly improved. Therefore, based on my data, 90% of the patients can experience significant improvement and resolution of their symptoms following MMA. Many, many factors influence the outcomes of MMA. The age of the patient, weight, genetic predisposition, severity of sleep apnea, gender, bone and soft tissue airway anatomy, how the operation was performed are just some of the factors.

Some patients have asked me about whether oral appliance success determines the success of the MMA. One needs to realize that the average maximum protrusion distance of the lower jaw is approximately 10mm. No one can tolerate a maximum protrusion the entire night and most people can handle less than 70% of the maximum protrusion. The typical oral appliance is about 4-5 mm advancement of the lower jaw (measured at the front teeth). If a patient experiences improvement with an oral appliance, then MMA is likely going to be successful. However, failure of oral appliance does not mean failure of MMA. MMA advances the upper jaw as well as the lower jaw. Many people think that it is the lower jaw that creates the room, but the upper jaw advancement is just as important in improving the airway dimension as well as reducing the collapsibility of the airway. Additionally, the typical MMA (when done properly) is often more than 15 mm advancement at the mandibular anterior teeth. The change in airway from MMA is magnitudes greater than any oral appliance. I will answer questions and make additional comments in a week as I will not be able to access a computer…

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