Persistent Daytime Sleepiness after Successful Maxillary-Mandibular Advancement Surgery: A Clinical Case Report

Abstract

Background: Continuous positive airway pressure is a cost-effective treatment of obstructive sleep apnea (OSA), but in case of craniofacial anomalies, which have a recognized role in OSA development, maxillary-mandibular advancement surgery is a recommended therapeutic option. Clinical Presentation: We describe a patient with severe OSA (apnea-hypopnea index = 42) treated by maxillary-mandibular advancement (MMA) surgery. Effective results were confirmed by polysomnography at 6 months post-surgery with normalization of the polysomnographic parameters (apnea-hypopnea index = 17) but due to persistent sleepiness, the patient was unable to resume his work. Conclusion: Maxillary-mandibular surgery can be a valid option for treating severe OSA associated with craniofacial anomalies. However, our results emphasize the need of critically assessing surgical approaches and the need to redefine success for OSA management.