Surgery for the treatment of snoring efficacy

       There are many surgical methods to treat snoring, most of which have a less than stellar success rate, but there is one surgical procedure that rivals ventilator therapy and can cure almost all snorers who have failed other methods of treatment, as well as those who have severe obesity and receding jaw deformities. This procedure is the maxillary and mandibular advancement.  The principle of maxillary and mandibular advancement for snoring is to make the upper and lower jaws move forward as much as possible through surgery, so that the upper airway can be dilated and the patient’s tongue root is less likely to fall back and the pharyngeal cavity is less likely to collapse and shrink during sleep. The principle is to move the upper and lower jaw as far forward as possible without seriously affecting the patient’s facial appearance, so as to maximize the expansion of the upper airway. For patients with normal facial shape, bimaxillary advancement may cause the patient’s facial protrusion, especially for yellow and black people, because yellow people have a slightly convex facial shape and black people have a convex facial shape, which is different from the straight facial shape of Caucasians. Computer-aided design and surgical simulation prediction systems provide an effective solution to this problem. Special preoperative preparation includes X-ray cephalometric analysis, preoperative prediction analysis of orthognathic surgery, plaster model surgery, and production of occlusal plates. Pre-operative treatment with continuous positive pressure ventilation is usually required for one week. During surgery, the upper and lower jaws are incised and moved forward about 10 mm, while the titanium plate and titanium nail are fixed afterwards, and the operation takes about 3-5 hours, and the patient is admitted to the intensive care unit for 1-3 days after surgery and discharged from the hospital 7-10 days after surgery, and the whole hospital stay is about 2-3 weeks. After surgery, the upper and lower jaws were fixed by traction for 4 weeks to maintain the occlusal relationship and the stability of the bone block, and then reviewed regularly.  After surgery, patients with normal facial shape may have slightly convex facial shape, slightly full upper lip, smaller nasolabial angle, etc., while patients with receding mandibular deformity before surgery obtained improved facial appearance after surgery due to chin advancement. In almost all patients, snoring was significantly reduced or disappeared, and more than 90% of the patients reduced their breath-holding by more than 50% and less than 20 times/hour compared with the preoperative period.  The main postoperative discomfort of patients included pain and swelling in the operated area and temporary lower lip numbness. Some patients have mild postoperative disorder of occlusal relationship, which can be restored after adjustment or orthodontic treatment.  Bimaxillary advancement is currently the most effective treatment for snoring in surgery. For snoring patients who strongly hope to achieve a cure with jaw dysplasia through surgery, bimaxillary advancement is not the best choice.