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A 26-year-old male with an AHI of only 7.9 suffered from severe snoring, daytime sleepiness, and lethargy. 3D CT scans revealed a receding jaw, short face, and narrow airway. Through a combination of invisible braces and MMA maxillofacial repositioning surgery, airway space, deep bite, occlusion, and lower facial proportions were simultaneously improved. This case demonstrates that mild sleep apnea cannot be diagnosed solely based on AHI.

A sleep apnea patient had to sleep in a separate room with his girlfriend due to severe snoring. After undergoing 3D customized orthognathic surgery and chin advancement surgery, I was most happy when I returned for a follow-up visit six months after the operation. The happiest thing was that my snoring had improved, my girlfriend no longer complained, and I could finally sleep in separate rooms. This case not only improved the patient's sleep quality, but also restored the couple's relationship, demonstrating the importance of sleep apnea treatment in improving the quality of life.

A patient with severe sleep apnea (AHI=69.8) decided to seek treatment because of severe snoring that affected his family's quality of life, especially after the birth of his child, and daytime sleepiness. After trying non-surgical methods such as side sleeping, positive pressure respirators, and anti-snoring braces with limited results, I finally chose to undergo MMA orthognathic surgery. After the operation, the AHI dropped from 69.8 to 13, and the minimum blood oxygen concentration during sleep increased from 53% to 83%. This not only improved the mental and physical strength, but also made the family no longer need to wear earplugs to sleep.

A patient with moderate to severe sleep apnea had a minimum blood oxygen concentration of only 44% during sleep. Not only did he suffer from severe snoring, but he also experienced dangerous breathing difficulties at night. Through the 3D customized orthognathic surgery performed by Dr. Jiang Houren of Fenghua United Clinic, the maxillary bone was moved forward by 6mm and the mandibular bone was moved forward by 12mm. This not only improved the problem of respiratory tract stenosis, but also solved the problem of facial distortion. After the operation, the patient's sleep quality has been significantly improved, snoring is no longer a problem, and the airway expansion has brought unprecedented smoothness.

This is a patient with extreme sleepiness. His Epworth Sleepiness Scale score is 17. If the score is over 10, it is considered to have reached the level of sleepiness that requires medical intervention. The sleep report he brought from the hospital showed that his AHI was as high as 64.5 (AHI>30 is severe sleep apnea) and his lowest blood oxygen level reached 60%. For patients with retruded mandible and severe sleep apnea, orthognathic surgery (Maxillo-Mandibular Advancement, MMA) should be one of the priority treatment options, especially since this patient is completely unable to accept having to wear a positive pressure ventilator for a long time. The CT scan after the operation showed that the narrow and blocked airway had been widened and supported through the reorganization of the upper and lower jaws. At the same time, the face shape, jaw line, tooth angle and bite state also benefited from the orthognathic surgery. Most importantly, the postoperative sleep report showed that the AHI had dropped to 4.3, which is the same as the normal standard, and the minimum blood oxygen level had increased to 83%. Subjectively, in addition to greatly reducing snoring, he felt much more energetic during the day and was not sleepy.

Orthognathic surgery was originally designed to improve the bite and appearance of the patient. However, in the field of treating obstructive sleep apnea, orthognathic surgery (maxillo-mandibular advancement/MMA) has become a means to tighten the collapsed (relaxed) muscles rather than an end. Improvement in appearance and bite has become an added value of maxillo-mandibular advancement.