Obstructive sleep apnea (OSA) is the most common type of sleep apnea and is caused by obstruction of the upper airway. It is characterized by repetitive pauses in breathing during sleep, despite the effort to breathe, and is usually associated with a reduction in blood oxygen saturation. These pauses in breathing are caused by the collapse of soft tissues of the oral cavity and throat. The most effective therapy for OSA is continuous positive airway pressure (CPAP) which is delivered by a machine that pushes a controlled stream of air through a mask worn over the nose, mouth, or both. The additional air pressure splints open the relaxed muscles and keep the airway patent. CPAP is the first line treatment for OSA and essentially cures the condition while it is used.
• Uvulopalatopharyngoplasty (UPPP): removes the tonsils, uvula, and a portion of the soft palate in the back of the throat. Success rates average about 50% or less over the long term. UPPP is among the most painful treatments for sleep apnea, and recovery takes several weeks. • Maxillomandibular advancement (MMA): the most effective surgical procedure currently available to treat sleep apnea (not including tracheostomy). MMA moves the upper (maxilla) and lower (mandible) jaws forward which opens the airway and prevents collapse during sleep. MMA was once thought to be fairly invasive, but has shown to be less painful than UPPP. In general, patient perceptions of surgical outcome have been very favorable. The success rate is usually between 80% and 100%, with a long-term success rate approaching 90%. Although maxillomandibular advancement is considered a fairly invasive procedure, the associated surgical risks are low, including bleeding, infection, malocclusion and permanent numbness. A survey of patients who had MMA found that the surgery changed their facial appearance, but most people thought it was a change for the better.