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Introduction <p>Obstructive sleep apnoea syndrome (OSAS) is a common primary sleep&#xa0;disorder with repetitive partial or complete upper airway collapse during sleep.&#xa0;Continuous positive airway pressure (CPAP) is the gold standard treatment for adults&#xa0;with OSA, however long-term CPAP adherence can be very low. Surgical treatment&#xa0;can be an effective option, especially in presence of maxillofacial anatomical&#xa0;deformities.</p> Case Summary <p>We present the case of a 29-year-old man with severe OSAS, no right&#xa0;mandibular ramus, and a deformity of the right mandibular body. The surgical&#xa0;procedure included positioning of a patient-specific total temporomandibular joint (TMJ)&#xa0;prosthesis and associated maxillomandibular advancement (MMA).</p> Discussion <p>We achieved an apnoea decrease &gt; 90% (AHI to 5.2/hour of sleep).&#xa0;Moreover, the aesthetics and chewing improved dramatically. Even if longer follow-up&#xa0;is needed to assess the postoperative stability of the bone position and sleep apnoea&#xa0;reduction, simultaneous MMA and TMJ reconstruction allowed us to obtain excellent&#xa0;results.</p>

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Orthognathic Surgery and TMJ Prosthesis to Treat an OSAS Patient Without Ascending Ramus and TMJ Since Childhood: A Case Report

  • 期刊论文

  • 发表日期：

    2026年3月16日

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  • Andrea Varazzani,
  • Laura Tognin,
  • Tito Poli,
  • Marilena Anghinoni

摘要

Introduction

Obstructive sleep apnoea syndrome (OSAS) is a common primary sleep disorder with repetitive partial or complete upper airway collapse during sleep. Continuous positive airway pressure (CPAP) is the gold standard treatment for adults with OSA, however long-term CPAP adherence can be very low. Surgical treatment can be an effective option, especially in presence of maxillofacial anatomical deformities.

Case Summary

We present the case of a 29-year-old man with severe OSAS, no right mandibular ramus, and a deformity of the right mandibular body. The surgical procedure included positioning of a patient-specific total temporomandibular joint (TMJ) prosthesis and associated maxillomandibular advancement (MMA).

Discussion

We achieved an apnoea decrease > 90% (AHI to 5.2/hour of sleep). Moreover, the aesthetics and chewing improved dramatically. Even if longer follow-up is needed to assess the postoperative stability of the bone position and sleep apnoea reduction, simultaneous MMA and TMJ reconstruction allowed us to obtain excellent results.