About this trial
This study looks at how jaw surgery called maxillomandibular advancement with counterclockwise rotation affects breathing during sleep in people with moderate to severe obstructive sleep apnea who cannot tolerate standard treatments such as Continous Positive Airway pressure treatment. The participants are followed over time to see whether the surgery improves sleep apnea symptoms, daytime sleepiness, and airway size, and whether these improvements last. Advanced three-dimensional imaging and airflow analysis are used to better understand how the surgery changes the airway and breathing. The goal is to evaluate the long-term effectiveness and safety of this surgical treatment.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Clinical diagnosis of obstructive sleep apnea with AHI ≥15 events/h.
Residence and/or registration in Dalarna County
Body mass index (BMI; kg/m²) between 15 and 35
Documented failure of CPAP or mandibular advancement therapy.
Disqualifiers
Medical conditions contraindicating general anesthesia.
American Society of Anesthesiologists Physical Status (ASA) Class III-VI
Central sleep apnea
Narcolepsy
Trial design
Single group
Treatments tested in this trial
Maxillomandibular advancement surgery with counterclockwise rotation
Procedure/SurgeryMaxillary advancement by LeFort I osteotomy and mandibular advancement by bilateral sagittal split osteotomy
Treatment groups
Trial outcomes
Primary outcomes
Apnea Hypopnea Index (AHI/h)
Change in AHI/h. Lower value means better outcome, value \< 5 is considered healthy.
Secondary outcomes
Upper airway volume
Changes in upper airway volume measured in mm\^3.
Airway velocity
Changes in airway velocity measured in m/s
Epworth Sleepiness Scale (ESS)
Assessment of daytime sleepiness using Epworth Sleepiness Scale before and after treatment. Minimum score 0, maximum 24. Higher scores mean a worse outcome,
Blood pressure
Assessment of the effect of surgery on both systolic and diastolic blood pressure and blood pressure medication, mmHg.
Sponsors and contacts
Click on the lead sponsor to view all of their trials.
Jani Talvilahti
Lead sponsor
Dalarna County Council, Sweden
Sponsor institution