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A young man was troubled by severe obstructive sleep apnea (OSA), with an AHI index as high as 55.8, and symptoms such as loud snoring, daytime sleepiness, headaches, and difficulty concentrating. Because he was unwilling to use a positive-pressure respirator, he underwent mandibular advancement surgery (MMA) combined with chin advancement surgery to successfully expand the airway space. The AHI dropped to 3.9 6 months after the operation, and his symptoms were significantly improved. This case demonstrates the therapeutic effect of MMA surgery on patients with severe OSA, providing patients with a treatment option that does not require respirators.

This 50-year-old woman suffered from severe sleep apnea (AHI = 40.5), with symptoms including severe daytime sleepiness (ESS = 17) and annoying snoring. Interestingly, a CT scan revealed that, in addition to the expected narrowing of her airways, she had undergone a Wassmund and Kole procedure in her youth. This procedure involves extracting one premolar from each side of her upper and lower jaws, then repositioning the upper and lower jaws through bone cutting to correct a protruding mouth.

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.

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.

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.

This case shares the treatment experience of a patient with moderate sleep apnea (AHI 22.9). The patient had sleep problems due to mandibular and chin retraction, and was unable to adapt to CPAP treatment. Through 3D customized orthognathic surgery, using the treatment method of counterclockwise rotation and forward movement of the upper and lower jaw bones (CCW-MMA), the 6-month follow-up showed that the AHI dropped to 2.7, successfully improving the symptoms of sleep apnea, while improving the Appearance, the patient was quite satisfied with the surgical results.