METHOD FOR ORTHOGNATHIC SURGERY WITH MAXILLA-MANDIBULAR EXTENSION FOR PERSONS WITH OBSTRUCTIVE SLEEP APNEA SYNDROME Russian patent published in 2017 - IPC A61B6/00 A61B17/24 

FIELD: medicine.

SUBSTANCE: virtual computer simulation of the operation is performed. During simulation, an increase in the volume of the respiratory spaces of the pharynx is taken into account. To do this, during planning of osteotomy fragments movement, positions of the following points and angle are considered: Pog′ - projection of the front point of the chin bone contour Pog (pogonion) on the soft tissue chin contour, MxI - point designating the incisal edge of the maxillary incisor, MxOP angle - slope of the occlusal plane of the maxilla, defined as an angle between the occlusal plane line and the true vertical line of the face. Further, virtual movement of the jaws in space is performed according to these points and angle, taking into account the aesthetic changes in the face. Pog' point extension is performed in the sagittal plane with respect to the true vertical line of the face (TVL) to the "-0.7" mm position in women and "-1.7" mm in men, according to the cephalometric analysis of Arnett/McLaughlin. MxI point extension is performed in the sagittal plane relative to the TVL to the "-7" mm position in women and "-10.3" mm in men, according to the cephalometric analysis of Arnett/McLaughlin. The angle of Mx OP inclination is changed with respect to the TVL to the 93.8° position in women and 93.6° in men, according to the cephalometric analysis of Arnett/McLaughlin. Based on the virtual 3D movements of the upper and lower jaws fragments, a spotting template is designed and manufactured using a 3D printer. Bilateral sagittal osteotomy of the lower jaw and osteotomy of the upper jaw are performed at the level of Le Fort I with maxillo-mandibular extension to a distance determined by the template.

EFFECT: method allows to expand the respiratory spaces in the soft palate projection, to eliminate its occlusion with obstruction during sleep, to provide aesthetically correct position of the anatomical formations of the given area: chin, upper jaw, lower and upper lips, facial proportions as a whole and relative to each other by extending the chin of the lower jaw forward in the sagittal plane and extending the upper jaw forward with the complex of palate soft tissues attached to it.

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