Digital-Assisted Orthognathic Surgery For Osas Management

This case demonstrates the efficacy of computer-assisted orthognathic surgery in addressing concurrent skeletal malocclusion and obstructive sleep apnea syndrome (OSAS) in a young adult, highlighting its dual functional and aesthetic benefits. Patient: Xie XX, Female, 25 years old History: A 25-year-old female with a 20-year history of maxillary protrusion and mandibular retrognathia causing facial deformity and malocclusion, and associated sleep-disordered breathing, was admitted for management of her conditions after completing pre-surgical orthodontics as part of recommended combined orthodontic and orthognathic therapy. Examination: - Facial disproportionality with mandibular retrusion -Dental midline deviation (2mm left) -increased nasolabial angle (>90°) -Skeletal Class II malocclusion (6mm overbite, Angle Class I molars) Investigations: -Narrow retrolingual space (3.00mm) -PSG-confirmed moderate OSAS:Apnea-Hypopnea Index (AHI): 26.9/h; Lowest Oxygen Saturation (SpO₂): 91%; Maximum Hypopnea Duration: 89 s; Maximum Apnea Duration: 50 s. Diagnoses: 1. Malocclusion 2. OSAS 3. First and second branchial arch syndrome Treatment: LeFort I osteotomy + Bilateral sagittal split ramus osteotomy (BSSRO) + Genioplasty 1. Significant improvement in respiratory symptoms postoperatively. 2. Digital surgical planning enabled counterclockwise bimaxillary rotation, achieving concurrent airway expansion and facial aesthetic enhancement. 3. Preoperative digital airway volume prediction optimized osteotomy design, substantially reducing surgical risks. This case establishes a reproducible clinical protocol for managing skeletal deformities with concomitant OSAS, highlighting the pivotal role of digital technology in complex orthognathic procedures.