1009 Surgery: Problem and Solution. Temporomandibular Joint Reconstruction For Treating Obstructive Sleep Apnea After Cosmetic Surgery

Abstract Introduction Orthognathic surgery is often considered for the treatment of obstructive sleep apnea (OSA); however, in some circumstances, specific interventions may precipitate OSA. Report case(s) A 34 year-old female presented with complaints snoring and fragmented sleep. She had undergone bimaxillary osteotomy mandibuloplasty cosmetic reasons outside country 2019. Prior to surgery, she was asymptomatic did not snore. Post operatively, developed snoring, witnessed apneas, sleep, daytime sleepiness. home test revealed severe Respiratory Event Index (REI) 66.4/hr. initially treated Positive Airway Pressure (PAP) while seeking oral consultation. PAP via nasal mask effective residual Apnea Hypopnea (AHI) 3/hr., but patient difficulty tolerating due aerophagia, nausea, eructation, despite limiting pressures 5-7cm H2O. In 2022, successfully underwent temporomandibular joint (TMJ) reconstruction total prosthesis, TMJ fat grafting, bilateral coronoidectomy, maxillary bone plate partial inferior turbinatectomy. reported resolution significant symptomatic improvement after surgical revision. Repeat testing 1 month REI 0.6/hr. Conclusion This case illustrates potential development OSA following orthognathic surgery. Patients providers should be aware this complication when pursuing intervention. Support (if any)