Case Report: Treating obstructive sleep apnea with maxillomandibular advancement surgery in a case with a previously reconstructed mandible

Background 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. Clinical presentation A 53-year-old male, who previously received mandibular reconstruction with a fibula flap, underwent MMA for severe OSA [apnea hypopnea index (AHI) = 35.2]. 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. Conclusion 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.