Sleep Apnea Surgery

Maxillomandibular advancement

Maxillomandibular advancement moves the upper and lower jaws forward to enlarge the airway behind the palate and tongue. It can be an effective option for patients whose airway anatomy contributes to obstructive sleep apnea.

Drug-induced sleep endoscopy (DISE)

DISE allows the airway to be evaluated while a patient is sedated in a sleep-like state. This helps identify the level and pattern of collapse so treatment can be matched to the patient’s anatomy.

How Jaw Surgery Improves the Airway

By correcting the underlying bone position that narrows the airway, orthognathic (jaw) surgery can significantly improve chronic mouth breathing, obstructive sleep apnea, and poor sleep quality with daytime fatigue. Unlike removable devices or soft-tissue adjuncts that offer temporary relief, repositioning the jaws addresses the root cause for a long-term solution.

Orthodontics or No Orthodontics

For patients with sleep apnea who already have a healthy bite and good dental alignment, surgery can often be performed without braces or aligners. When orthodontics is needed, we coordinate with any orthodontist in Central Oregon, using braces or clear aligners such as Invisalign®, with close communication on surgical timing.

Digital Surgical Planning

We use Virtual Surgical Planning (VSP) and advanced 3D imaging to plan your surgery precisely, with simulated outcomes beforehand, shorter operating time, more predictable healing, and custom titanium plates for select cases. When appropriate, surgery is performed on-site in our office with personalized anesthesia and multimodal, narcotic-sparing pain management.

How MMA Compares — The Evidence

Maxillomandibular advancement (MMA) moves the upper and lower jaws forward to physically enlarge the airway, addressing the skeletal cause of obstruction. Across published studies, MMA has one of the highest and most durable success rates of any treatment for obstructive sleep apnea. The approximate figures below are drawn from the medical literature and reflect typical ranges — individual results vary based on anatomy, severity, and adherence.

• Maxillomandibular advancement (MMA): roughly 85–90% surgical success (a 50% or greater reduction in AHI to a low residual level), with results that tend to remain stable long-term. Often considered the most effective surgical option for moderate-to-severe OSA.

• CPAP: the gold standard and highly effective at controlling apnea when worn every night — but real-world benefit is limited by adherence, with a large share of patients discontinuing or using it inconsistently over time.

• Mandibular advancement appliance (oral appliance): approximately 50–60% success, best suited to mild-to-moderate OSA and generally less effective for severe disease.

• Hypoglossal nerve stimulation (Inspire): roughly a 65–75% responder rate in carefully selected patients, with effectiveness depending on candidacy criteria such as body weight and the pattern of airway collapse.

• Soft-tissue and laser procedures (e.g., laser palatoplasty): generally lower and less durable success for moderate-to-severe OSA, since they address soft tissue rather than the underlying skeletal airway.

• Maxillary expansion without surgery: effective primarily in growing children; evidence for non-surgical expansion in adults is limited, which is why surgically assisted expansion is used when skeletal widening is needed.

Because MMA corrects the bone position that narrows the airway, it offers a long-term solution rather than nightly device dependence. We’ll review your imaging, sleep study, and overall health to determine whether MMA — alone or alongside other therapies — is the right path for you.