Electronic Thesis and Dissertation Repository


Master of Clinical Science




Tassi, Ali

2nd Supervisor

Shimizu, Michael




Obstructive sleep apnea (OSA) is a common sleep disorder in which complete or partial airway obstruction causes disruptive sleep and excessive daytime sleepiness. Highly successful treatment outcomes for OSA utilizing maxillomandibular advancement (MMA) surgery have been reported. However, due to the large degree of surgical advancement that is performed, concerns may exist regarding the final aesthetic result.


To evaluate facial profile changes in patients treated for OSA with MMA surgery utilizing panels of oral and maxillofacial surgeons (OMFS), orthodontists (ORTHO) and laypeople (LAY).


This was a retrospective cohort analysis. Pre- and post-treatment silhouettes of patients who underwent MMA surgery for OSA (n=22) were generated from patient profile photographs. The silhouettes were shown in random order to a panel of judges consisting of OMFS (n=48), ORTHO (n=58), and LAY (n=70). The judges were asked to assess patient silhouettes on a visual analogue scale (VAS) based on attractiveness, paying particular attention to facial balance.


Post-surgical silhouette ratings were significantly more positive, or neutral, in 21 of 22 patients when compared to pre-surgical ratings. The mean increase in aesthetic score post-surgically was found to be 1.9 for all groups combined, 2.1 for OMFS and ORTHO, and 1.6 for LAY. There was a significant difference in the way that OMFS and ORTHO rated silhouettes as compared to LAY for 12 of 22 patients (p < 0.05). Mean aesthetic score change was not significant between OMFS and ORTHO ratings for any of the 22 patients.


In general, MMA surgery for the treatment of OSA does not have a negative impact on facial aesthetics. All groups of evaluators felt that post-surgical aesthetic changes were positive in the vast majority of patients. OMFS and ORTHO reported a higher positive post-surgical change than LAY.