Maxillomandibular Advancement Guided by the Barcelona Line, a Facial Soft-Tissue Reference, in Patients with Obstructive Sleep Apnea: A Feasibility Study.
- 1Department of Oral and Maxillofacial Surgery, Universitat Internacional de Catalunya (UIC), 08195 Barcelona, Spain.
- 2Institute of Maxillofacial Surgery, Teknon Medical Center, 08022 Barcelona, Spain.
Abstract
Maxillomandibular advancement (MMA) represents an effective surgical treatment for individuals with obstructive sleep apnea (OSA) when conservative therapies fail. However, variability in surgical planning methods limits predictability and standardization of outcomes. This retrospective cohort study evaluated clinical and polysomnographic outcomes of MMA planned using the Barcelona Line (BL), and to explore the relationship between BL-guided skeletal positioning and treatment response in adult patients with moderate to severe OSA. Twenty-six consecutive patients (N = 26) underwent standardized virtual planning, surgery, and follow-up, with preoperative and postoperative polysomnography and three-dimensional CBCT analysis. Skeletal movements, upper airway changes, and sleep-related outcomes were assessed. Mean advancement at pogonion was 19.0 ± 4.7 mm. The apnea-hypopnea index decreased significantly from 45.8 ± 11.6 to 6.6 ± 6.6 events/h (mean relative reduction of 85.6 ± 10.9%). Treatment success was achieved in 25/26 patients (96.2%; 95% CI 81.1-99.3) and cure in 22/26 patients (84.6%; 95% CI 66.5-93.9). Daytime sleepiness improved, with ESS scores decreasing from 12.2 ± 1.2 to 1.5 ± 0.4. Total upper airway volume increased from 26.46 ± 2.88 mm³ to 45.32 ± 5.41 mm³. BL-guided MMA is a feasible planning approach associated with substantial clinical improvement in selected OSA patients. The results likely reflect a combination of surgical advancement magnitude and patient selection. Comparative studies are required to determine the independent contribution of the BL.
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BibTeX
@article{hernandezalfaro2026maxillomandibular,
title = {{Maxillomandibular Advancement Guided by the Barcelona Line, a Facial Soft-Tissue Reference, in Patients with Obstructive Sleep Apnea: A Feasibility Study.}},
author = {Federico Hernández-Alfaro and Maria Cuevas-Nunez and Francesc Duran-Valles and Irene Méndez-Manjón and Maria Giralt-Hernando and Adaia Valls-Ontañón},
journal = {Craniomaxillofacial trauma \& reconstruction},
year = {2026},
month = oct,
doi = {10.3390/cmtr19040040},
url = {https://europepmc.org/article/MED/42924651},
note = {CC BY},
}
RIS
TY - JOUR
TI - Maxillomandibular Advancement Guided by the Barcelona Line, a Facial Soft-Tissue Reference, in Patients with Obstructive Sleep Apnea: A Feasibility Study.
AU - Federico Hernández-Alfaro
AU - Maria Cuevas-Nunez
AU - Francesc Duran-Valles
AU - Irene Méndez-Manjón
AU - Maria Giralt-Hernando
AU - Adaia Valls-Ontañón
PY - 2026
DA - 2026/10/09
JO - Craniomaxillofacial trauma & reconstruction
DO - 10.3390/cmtr19040040
UR - https://europepmc.org/article/MED/42924651
AB - Maxillomandibular advancement (MMA) represents an effective surgical treatment for individuals with obstructive sleep apnea (OSA) when conservative therapies fail. However, variability in surgical planning methods limits predictability and standardization of outcomes. This retrospective cohort study evaluated clinical and polysomnographic outcomes of MMA planned using the Barcelona Line (BL), and to explore the relationship between BL-guided skeletal positioning and treatment response in adult patients with moderate to severe OSA. Twenty-six consecutive patients (N = 26) underwent standardized virtual planning, surgery, and follow-up, with preoperative and postoperative polysomnography and three-dimensional CBCT analysis. Skeletal movements, upper airway changes, and sleep-related outcomes were assessed. Mean advancement at pogonion was 19.0 ± 4.7 mm. The apnea-hypopnea index decreased significantly from 45.8 ± 11.6 to 6.6 ± 6.6 events/h (mean relative reduction of 85.6 ± 10.9%). Treatment success was achieved in 25/26 patients (96.2%; 95% CI 81.1-99.3) and cure in 22/26 patients (84.6%; 95% CI 66.5-93.9). Daytime sleepiness improved, with ESS scores decreasing from 12.2 ± 1.2 to 1.5 ± 0.4. Total upper airway volume increased from 26.46 ± 2.88 mm³ to 45.32 ± 5.41 mm³. BL-guided MMA is a feasible planning approach associated with substantial clinical improvement in selected OSA patients. The results likely reflect a combination of surgical advancement magnitude and patient selection. Comparative studies are required to determine the independent contribution of the BL.
SN - 1943-3875
SN - 1943-3883
ER -