Maxillomandibular Advancement for OSA-Esthetic and Airway Considerations

Sleep Apnea Surgery Center
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[@nexus7c0]

Thank you Dr. Li! We as sleep apnea patients are very grateful for your work.

[@Wavewave583]

Thanks for posting this for us Dr. Li!

[@windstorminator]

Great video 👏 👏

[@Butterkipferl]

as I understood it in the video, a mandibular deficiency correlates with tongue base collapse while maxillary deficiency correlates with lateral wall collapse of the airway. Would it make sense then to assess the nature of the obstruction with a DISE before planning the movements of the MMA surgery?

[@maxaffe3195]

yeah DISE is really useful...

[@maxaffe3195]

but his contra points are still true about it

[@Sunrise-fr9jb]

23:50 how exactly did that patients jaws change position overtime? mouth breathing?

[@shuikai272]

I feel like the problem isn't necessarily neuromuscular or arousal threshold, but like you said, poor tension in the velopharyngeal muscles. I think performing osteotomies and disjunction at the PMS is a mistake, because the majority of muscle attachments are near the medial pterygoid plates / pterygoid hamulus area which is on the other side of the suture. Making those muscle attachments more forward away from the occipital, and more wider apart from each other might yield a better result.
In addition, when you look at natural maxillas the pterygoid plate is attached to the posterior maxilla. The pterygoid plate grows with the maxilla. If you look at some of the diagrams it shows a suture or line 2/3 down the pterygoid plate. Repositioning the maxilla away from the pterygoid plates seems unnatural.

[@yahyaelmi8435]

is why Myofunctional therapy helps ?

[@Sunrise-fr9jb]

How are you suppose to avoid that tho if you get jaw surgery? Every surgeon detaches that joint to move the maxilla forward

[@floracatacun8886]

*Promosm*