A Structural Solution for Obstructive Sleep Apnoea
Maxillomandibular advancement (MMA) is a surgical procedure used to treat obstructive sleep apnoea by repositioning the upper and lower jaws.
By moving both jaws forward, the airway is enlarged and stabilised—reducing collapse during sleep and improving breathing.
MMA is one of the most effective surgical treatments available for appropriately selected patients.
How MMA Works
Obstructive sleep apnoea is often caused by narrowing or collapse of the airway, particularly at multiple levels.
MMA addresses this by:
- Advancing the upper jaw (maxilla)
- Advancing the lower jaw (mandible)
- Increasing the space behind the tongue and soft palate
- Reducing airway collapse throughout the night
Unlike treatments targeting a single structure, MMA improves airway dimensions more comprehensively.
Who This Treatment Is For
MMA may be appropriate if you:
- Have moderate to severe obstructive sleep apnoea
- Are unable to tolerate CPAP therapy
- Have anatomical features contributing to airway narrowing
- Require a definitive, long-term solution
It is particularly effective in patients where obstruction occurs at multiple levels of the airway.
Assessment and Planning
Careful assessment is essential before considering MMA.
This typically includes:
- Sleep study results
- Clinical examination
- Imaging of the jaws and airway
- Drug-induced sleep endoscopy (DISE) where indicated
This allows the procedure to be planned precisely and ensures it is appropriate for your specific pattern of obstruction.
The Procedure
MMA is performed under general anaesthetic.
- The upper and lower jaws are carefully mobilised
- Both are repositioned forward in a controlled manner
- The new position is stabilised using fixation plates
All incisions are made inside the mouth, avoiding visible external scars.
The procedure builds on techniques used in orthognathic surgery, adapted to improve airway function.
Recovery
Recovery follows a structured pathway.
- Swelling is expected and gradually settles over several weeks
- A modified diet is required during early healing
- Most patients return to normal activities within a few weeks
Close follow-up ensures appropriate healing and adjustment to the new jaw position.
Results
MMA can lead to significant improvement in:
- Frequency and severity of apnoea events
- Oxygen levels during sleep
- Daytime alertness and fatigue
- Overall quality of life
Results are long-lasting, reflecting a change to the underlying airway structure rather than a temporary intervention.
MMA vs Other Surgical Treatments
Different surgical options target different levels of the airway.
Soft tissue procedures (e.g. UPPP)
- Address palate and soft tissue collapse
- More limited effect in multi-level obstruction
Hypoglossal nerve stimulation
- Supports airway opening during sleep
- Does not change airway anatomy
MMA
- Enlarges the airway by repositioning the jaws
- Addresses obstruction at multiple levels
- Provides a more definitive, structural solution
A tailored approach ensures the most appropriate treatment is selected.
A Considered Approach to Sleep Surgery
MMA is a significant procedure and is recommended only where appropriate.
Our approach prioritises:
- Careful patient selection
- Precise surgical planning
- Integration with the overall treatment pathway
- Outcomes that are predictable and durable
Consultation
A detailed consultation allows for full assessment of your sleep apnoea, prior treatments, and suitability for surgical intervention.
Arrange a Consultation
For assessment of obstructive sleep apnoea and suitability for maxillomandibular advancement surgery in London, arrange a consultation to discuss your options in detail.