Maxillomandibular Advancement for OSA: Felonies and Misdemeanors

[@LaughinLoneStar]

Need for 3d printed titanium plates actually being highlighted here

[@SajidKhan-kt6rz]

What's limiting surgeons from advancing more than 4-5mm?

[@memhisrocks45]

Could be bad planning or patient doesn’t want a massive advancement due to more likely having issues. Also patient may want lower jaw when the only real way is double.

[@Sunrise-fr9jb]

dont know seems werid that they dont advance more

[@justdancetm2731]

most surgeons focus on the bite more than the aesthetic and function

[@shankar0cr]

lack of skills.

[@shuikai272]

A lot of the studies seem to indicate that genioplasty can reduce AHI, maybe depending on how it is cut, and definitely that genioglossus advancement on the other hand is on pretty unsteady ground. There is other literature studying cadavers which seemed to indicate that advancing the geniohyoid and/or genial tubercle can improve the lower points of the airway, and that the genioglossus is probably closer to the roots of the teeth which would explain why the GGA osteotomy doesn't work. Definitely mandibular advancement would be superior to genioplasty as you are advancing all the muscles. I mean clearly the genioglossus being attached to the tongue must be very important, especially for sleeping on the back.

[@Burneracct]

Maybe vertically shortening the chin could elevate the digastric and hyoid? If function follows form, I might intuitively think that a long lower anterior face height/hyperdivergent mandible could have functional issues

[@shuikai272]

@@Burneracct I feel like the vertical wouldn't really make much of a difference, I would say just do whatever will look best aesthetically. Most surgeons will bring the genioplasty up in order to decrease the bone gap anyway I guess.

[@amirtak9886]

My god now I'm having second thoughts about this surgery.

[@notthatguy4703]

Me too scary aff

[@miniweeddeerz1820]

YOU HAVE TO DO YOUR OWN RESEARCH. Figure out where your deficiencies lie skeletally and how to address them, both functionally and aesthetically. Don't go to any random surgeon. Don't trust any doctor to know what's best for you. Always ask question, always search for more knowledge. ITS YOUR FACE THEY ARE OPERATING ON. And find the best damn surgeon you can. Find someone who does idk 20 surgeries a week. It's worth the cost both functionally and aesthetically

[@amirtak9886]

@@miniweeddeerz1820 I decided not to go with the surgery, not worth the risk.

[@ew5770]

me too. not worth it

[@Alex-wx8be]

Why Felonies and Misdemeanors? Were this doctors charged of crimes?

[@lmclrain]

Very interesting

[@maxaffe3195]

stanley liu ...

[@joedimaggio3146]

How and why is that young girl getting MMA surgery? That seems preposterous...