Facial Mobility after Maxilla-Mandibular Advancement in Patients with Severe Obstructive Sleep Apnea Syndrome: A Three-Dimensional Study

Abstract

Introduction. The functional results of surgery in terms of facial mobility are key elements in the treatment of patients. Little is actually known about changes in facial mobility following surgical treatment with maxillomandibular advancement (MMA). Objectives. The three-dimensional (3D) methods study of basic facial movements in typical OSAS patients treated with MMA was the topic of the present research. Materials and Methods. Ten patients affected by severe obstructive sleep apnea syndrome (OSAS) were engaged for the study. Their facial surface data was acquired using a 3D laser scanner one week before (T1) and 12 months after (T2) orthognathic surgery. The facial movements were frowning, grimace, smiling, and lip purse. They were described in terms of surface and landmark displacements (mm). The mean landmark displacement was calculated for right and left sides of the face, at T1 and at T2. Results. One year after surgery, facial movements were similar to presurgical registrations. No modifications of symmetry were present. Conclusions. Despite the skeletal maxilla-mandible expansion, orthognathic surgical treatment (MMA) of OSAS patients does not seem to modify facial mobility. Only an enhancement of amplitude in smiling and knitting brows was observed. These results could have reliable medical and surgical applications.

The Effect of Orthognathic Surgery on Soft-Tissue Facial Asymmetry: A Longitudinal Three-Dimensional Analysis

“…For surface analysis, optical devices were used, with follow-up times ranging from 6 to 24 months 4,15-18 . Among the others, patients affected by Class III skeletal malocclusion 2,16 , jaws asymmetry 2,3,17 and obstructive sleep apnoea syndrome requiring maxilla-mandible advancement 18 , were investigated; classic anthropometric measurements, evaluations of facial symmetry, and assessments of facial mimicry were performed 2,3,[15][16][17][18][19] .…”

Juvenile Facial Growth and Mimicry: A Preliminary 3D Study

“…This allowed identifying the persistence of unique and characteristic mimic patterns, which were specific of every patient and consistent from childhood to young adulthood. Besides, previous studies postulated that facial surgery and aging have restricted influence on facial mobility in adult subjects .…”

“…Recently, 3D imaging systems have been used, for example, to evaluate facial soft tissues distribution in normal children and in patients after maxillofacial surgery . In this regard, despite the significant changes on the underlying facial bone structures, adult patients have been proven to maintain consistent facial movements before and after maxillo‐mandibular surgery, except for the smile, which amplitude appeared to increase in the majority of cases .…”