Factors associated with surgical outcomes following maxillomandibular advancement for obstructive sleep apnea: a systematic review and exploratory meta-analysis
Year: 2026
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: Maxillomandibular advancement (MMA) is one of the most effective surgical treatments for obstructive sleep apnea (OSA), but treatment response varies considerably among patients. We performed a systematic review and exploratory meta-analysis to evaluate factors associated with treatment response following MMA. The review protocol was registered with PROSPERO (CRD420251274643). PubMed, Scopus, ScienceDirect, and the Cochrane Library were searched for observational studies reporting postoperative outcomes together with factors associated with surgical response. Study quality was assessed using the ROBINS-I tool. Random-effects meta-analysis was performed when studies were sufficiently comparable; otherwise, findings were synthesized narratively. Thirteen studies met the inclusion criteria. Definitions of surgical success varied substantially across studies, although most used the Sher criteria or postoperative apnea–hypopnea index thresholds. Across six independent cohorts, the random-effects pooled surgical success rate was 70.7% (95% CI, 62.5%–77.7%), although this estimate should be interpreted cautiously because of methodological heterogeneity. Younger age, lower central apnea burden, and favorable cephalometric and upper airway characteristics were more consistently associated with improved treatment response, whereas evidence for body mass index, sex, baseline disease severity, and the magnitude of skeletal advancement was inconsistent. These findings support comprehensive patient selection integrating clinical, polysomnographic, and anatomical characteristics and underscore the need for prospective studies using standardized outcome definitions and validated prediction models.
Source: Scientific Reports
Authors: Mohammed Nadershah, Razan M. Baabdullah
Institution: King Abdulaziz University
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,690
OpenAlex ID: W7214520882
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