Patient's perception of the facial appearance after maxillomandibular advancement for obstructive sleep apnea syndrome

Purpose: The goal of this study was to evaluate the patient's perception of the facial appearance after maxillomandibular advancement (MMA) surgery fo r obstructive sleep apnea syndrome (OSAS). Patients and Methods: During a 14-month period, 58 patients underwent MMA f or OSAS. All of the patients underwent preoperative and postoperative cepha lometric analysis. Between 6 and 12 months after surgery, a questionnaire w as mailed to each patient. The questionnaire asked the patient to evaluate subjectively their postoperative facial appearance. Visual analog scale ([V AS] 0 to 10) was used to assess the extent of the facial changes. Results: Forty-four (76%) patients (39 men, 6 women) responded to the quest ionnaire. Cephalometric analysis revealed that 40 patients had maxillomandi bular protrusion postoperatively. Forty-two (96%) of the 44 patients report ed changes in their facial appearance (VAS, 4.8 +/- 2.5). Twenty-four (55%) patients reported favorable facial changes (ie, they were more attractive [15 patients] and/or more youthful). Fourteen patients gave neutral respons es (ie, they were no more or no less attractive). Four patients gave unfavo rable responses (ie. they were less attractive after surgery). Conclusion: The results suggest that most patients who underwent MMA for OS AS noted moderate changes in their facial appearance. Despite significant m axillomandibular protrusion based on the postoperative cephalometric analys is, more than 90% of the patients gave either positive or neutral responses to the changes in their facial appearance. (C) 2001 American Association o f Oral and Maxillofacial Surgeons.