MMA for OSA: The High-Stakes of Patient Selection - Critical Decision Points for the Otolaryngologist

PROGRAM DESCRIPTION: The evolving landscape of sleep surgery has positioned otolaryngologists as critical stakeholders in the comprehensive management of OSA patients. As precision sleep medicine advances, otolaryngologists are often the first surgical specialists to evaluate and direct patients toward appropriate interventions. While maxillomandibular advancement (MMA) demonstrates high efficacy in treating OSA, with success rates of 55-89%, the procedure's complexity demands sophisticated patient selection and counseling skills from all physicians involved in the care journey.
This session addresses the otolaryngologist's expanding role in identifying and appropriately referring MMA candidates. Recent studies indicate that surgical success heavily depends on careful patient selection, with factors such as sleep comorbidities, patient's expectations, skeletal characteristics, and OSA severity significantly influencing outcomes. The session provides evidence-based frameworks for patient evaluation, risk stratification, and preoperative counseling, emphasizing the otolaryngologist's vital role in the multidisciplinary approach to complex OSA cases.
Faculty will present critical decision-making algorithms integrating anatomical assessment, sleep test data, and clinical factors to optimize patient selection. Particular attention will be given to analyzing predictive factors for surgical success and failure, understanding perioperative risks, and managing patient expectations. The session will address essential aspects of coordinating care and navigating the complex perioperative period.
As healthcare systems increasingly emphasize precision medicine approaches to OSA treatment, otolaryngologists must be well-versed in all surgical options. This knowledge is crucial for maintaining the otolaryngologist's central role in modern sleep surgery and ensuring optimal patient outcomes through appropriate selection and counseling.

OUTCOME OBJECTIVE 1: Analyze key predictive factors for MMA success and failure in OSA patients based on anatomical, polysomnographic, behavioral and clinical criteria

OUTCOME OBJECTIVE 2: Implement a systematic approach to preoperative risk stratification and identify contraindications for MMA surgery

OUTCOME OBJECTIVE 3: Develop effective counseling strategies and coordinate care within a multidisciplinary surgical team approach

BACKGROUND STATEMENT: Otolaryngologists face increasing demands to guide OSA surgical care. With variable MMA success rates and significant perioperative considerations, a clear understanding of patient selection and risk stratification is crucial for optimal outcomes in the era of precision sleep surgery.

Comprehensive Otolaryngology Track Statement : This session addresses the comprehensive otolaryngologist's essential role in OSA patient care. Materials emphasize holistic airway evaluation, integration with multiple treatment modalities, and effective coordination across specialties for optimal surgical outcomes.