{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T09:23:56Z","timestamp":1774430636123,"version":"3.50.1"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Maxillomandibular advancement (MMA) serves as a surgical option for the management of obstructive sleep apnea (OSA). However, its application in patients with a previously reconstructed mandible is rarely reported and technically challenging. This paper reports a case of MMA for OSA in a patient who had undergone mandibular reconstruction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical presentation<\/jats:title>\n                    <jats:p>A 53-year-old male, who previously received mandibular reconstruction with a fibula flap, underwent MMA for severe OSA [apnea hypopnea index (AHI)\u2009=\u200935.2]. Virtual surgical planning with patient-specific guides and osteosynthesis plates were used to enable precise maxillary and mandibular advancement. Post-surgery, AHI decreased to 17.6, markedly improving daytime sleepiness. Complications were minimal, limited to transient paraesthesia and osteosynthesis material removal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case suggests that, when carefully planned and executed, MMA using patient-specific osteotomy guides and osteosynthesis plates can be a feasible, effective, and surgically safe treatment option for OSA in selected patients with a previously reconstructed mandible.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1758556","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T06:52:12Z","timestamp":1774421532000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Treating obstructive sleep apnea with maxillomandibular advancement surgery in a case with a previously reconstructed mandible"],"prefix":"10.3389","volume":"13","author":[{"given":"Ning","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centers (UMC), University of Amsterdam","place":["Amsterdam, Netherlands"]},{"name":"Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam","place":["Amsterdam, Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Pierre T. F.","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centers (UMC), University of Amsterdam","place":["Amsterdam, Netherlands"]},{"name":"Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam","place":["Amsterdam, Netherlands"]},{"name":"Department of Oral and Maxillofacial Surgery, Northwest Clinics","place":["Alkmaar, Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cornelis","family":"Klop","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centers (UMC), University of Amsterdam","place":["Amsterdam, Netherlands"]},{"name":"Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam","place":["Amsterdam, Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. Peter","family":"van Maanen","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, OLVG","place":["Amsterdam, Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"de Lange","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centers (UMC), University of Amsterdam","place":["Amsterdam, Netherlands"]},{"name":"Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam","place":["Amsterdam, Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1016\/j.smrv.2009.11.003","article-title":"Maxillomandibular advancement for the treatment of obstructive sleep apnea: a systematic review and meta-analysis","volume":"14","author":"Holty","year":"2010","journal-title":"Sleep Med Rev"},{"key":"B2","doi-asserted-by":"publisher","first-page":"15015","DOI":"10.1038\/nrdp.2015.15","article-title":"Obstructive sleep apnoea syndrome","volume":"1","author":"L\u00e9vy","year":"2015","journal-title":"Nat Rev Dis Primers"},{"key":"B3","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1007\/s11325-012-0707-1","article-title":"Volumetric analysis of the pharynx in patients with obstructive sleep apnea (OSA) treated with maxillomandibular advancement (MMA)","volume":"17","author":"Faria","year":"2013","journal-title":"Sleep Breath"},{"key":"B4","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1177\/0194599815611603","article-title":"Efficacy of maxillomandibular advancement examined with drug-induced sleep endoscopy and computational fluid dynamics airflow modeling","volume":"154","author":"Liu","year":"2016","journal-title":"Otolaryngol Head Neck Surg"},{"key":"B5","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1016\/j.jcms.2011.03.014","article-title":"3D Planning in orthognathic surgery: CAD\/CAM surgical splints and prediction of the soft and hard tissues results - our experience in 16 cases","volume":"40","author":"Aboul-Hosn Centenero","year":"2012","journal-title":"J Craniomaxillofac Surg"},{"key":"B6","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1016\/j.jcms.2014.12.003","article-title":"Splintless orthognathic surgery: a novel technique using patient-specific implants (PSI)","volume":"43","author":"Gander","year":"2015","journal-title":"J Craniomaxillofac Surg"},{"key":"B7","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1007\/s12663-015-0766-5","article-title":"Mandibular reconstruction: overview","volume":"15","author":"Kumar","year":"2016","journal-title":"J Maxillofac Oral Surg"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1833","DOI":"10.1097\/SCS.0000000000001058","article-title":"Sagittal split osteotomy on the previously reconstructed mandible with fibula free flap","volume":"25","author":"Kim","year":"2014","journal-title":"J Craniofac Surg"},{"key":"B9","doi-asserted-by":"publisher","first-page":"830","DOI":"10.1016\/j.ijom.2013.01.019","article-title":"Bilateral sagittal split osteotomy in a mandible previously reconstructed with a non-vascularized bone graft","volume":"42","author":"Mensink","year":"2013","journal-title":"Int J Oral Maxillofac Surg"},{"key":"B10","doi-asserted-by":"publisher","first-page":"e271","DOI":"10.1097\/GOX.0000000000000127","article-title":"The modifications of the sagittal ramus split osteotomy: a literature review","volume":"2","author":"B\u00f6ckmann","year":"2015","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"B11","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1097\/01.PRS.0000065910.66161.DD","article-title":"Osteotomy to treat malocclusion following reconstruction of the mandible with the free fibula flap","volume":"112","author":"Chang","year":"2003","journal-title":"Plast Reconstr Surg"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1238","DOI":"10.1097\/SCS.0b013e3181e5703a","article-title":"Role of a new orthognathic surgery in maxillomandibular reconstruction by free flaps","volume":"21","author":"Gennaro","year":"2010","journal-title":"J Craniofac Surg"},{"key":"B13","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1016\/j.ijom.2019.08.022","article-title":"Splintless orthognathic surgery in edentulous patients-a pilot study","volume":"49","author":"Ho","year":"2020","journal-title":"Int J Oral Maxillofac Surg"},{"key":"B14","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1093\/sleep\/19.2.156","article-title":"The efficacy of surgical modifications of the upper airway in adults with obstructive sleep apnea syndrome","volume":"19","author":"Sher","year":"1996","journal-title":"Sleep"},{"key":"B15","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1007\/s11325-016-1397-x","article-title":"Positional therapy in patients with residual positional obstructive sleep apnea after upper airway surgery","volume":"21","author":"Benoist","year":"2017","journal-title":"Sleep Breath"},{"key":"B16","doi-asserted-by":"publisher","first-page":"110968","DOI":"10.1016\/j.jbiomech.2022.110968","article-title":"Bone remodeling following mandibular reconstruction using fibula free flap","volume":"133","author":"Zheng","year":"2022","journal-title":"J Biomech"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1758556\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T06:52:34Z","timestamp":1774421554000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1758556\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,25]]},"references-count":16,"alternative-id":["10.3389\/fsurg.2026.1758556"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2026.1758556","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,25]]},"article-number":"1758556"}}