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Scientific Oral Presentations

Sleep Medicine

Session: Scientific Oral Presentation 3 - Sleep

Exploring Relationships Between Skeletal Changes and OSA Outcomes Following Maxillomandibular Advancement

Monday, October 13, 2025
10:18 AM - 10:24 AM EDT
Location: 136
Disclosure(s):
Lauren A. Howser, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Mohamed Faisal Kassir, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Mohamed A. Abdelwahab, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Maxillomandibular advancement (MMA) is a well-established surgical intervention for obstructive sleep apnea (OSA), designed to enlarge the upper airway and improve airflow. While effective in reducing the apnea-hypopnea index (AHI), the relationship between specific surgical measurements and postoperative improvements remains underexplored.

Methods: The relationship between specific skeletal measurements and postoperative polysomnography (PSG) outcomes was analyzed in 22 patients who underwent MMA at a single institution. Correlation analyses (Pearson or Spearman) were conducted depending on data normality.

Results: The overall success rate (AHI improvement >50%) was 100%. AHI decreased from a median of 64.3 to 11.3 (p < 0.0001) and the median oxygen desaturation index (ODI) decreased from 51.1 to 9.6 (p < 0.0001). Moderate negative correlations were observed between changes in upper incisor location, upper incisor rotation, mandibular advancement, and sella-nasion-point A angle with changes in AHI (r= -0.45, -0.51, -0.52, -0.44; all p< 0.05). Upper incisor angle was negatively correlated with ODI changes (r= -0.47, p=0.03), and postoperative occlusal plane was negatively correlated with supine AHI changes (r= -0.46, p=0.04). Pogonion advancement was negatively correlated with time spent < 90% SpO₂ (r= -0.50, p=0.02). Maxillary advancement (point A), bilateral sagittal split osteotomy, and BMI were not significantly correlated with PSG outcomes.

Conclusions: Key skeletal measurements, including mandibular advancement and upper incisor angle, are associated with improved sleep outcomes following MMA. Understanding the relationship between specific skeletal changes and postoperative results is critical for optimizing surgical planning and enhancing patient outcomes.

    Presenting Author(s)

  • Lauren A. Howser, MD

    Resident Physician
    Medical University of South Carolina
    Charleston, South Carolina, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • HB

    Hank F. Butehorn, IV, BA

    Clinical Research Fellow
    Medical University of South Carolina
    Charleston, South Carolina, United States

    Disclosure information not submitted.

  • Mohamed Faisal Kassir, BS

    MD-PhD Student
    Medical University of South Carolina
    Charleston, South Carolina, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • SN

    Shaun A. Nguyen, MD

    Professor and Director of Clinical Research
    Medical Univ of South Carolina Dept of OTO
    CHarleston, SC, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • Mohamed A. Abdelwahab, MD

    Sleep and Facial Skeletal Surgery, Director
    Medical University of South Carolina
    Charleston, SC, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.