Abstract: PURPOSE: To overcome the oriental face type of micro convex constraints, advancing the maxilla and mandible in order to achieve good surgical effect for patients with severe obstructive sleep apnea-hypopnea syndrome (OSAHS). METHODS:Sixteen cases with severe OSAHS (15 males and 1 female) were included. The mean age was 36.81±10.41 years, BMI (body mass index, BMI) was (27.35±3.67) kg/m2, AHI was (61.59±15.78), LSAT was (72.13±9.63)%. Cephalometric analysis and PSG were conducted preoperatively and postoperatively. Q-UPPP and maxillomandibular anticlockwise rotation advancement were performed, in which the maxillae advancing distance was controlled to be 6-8 mm and mandible moved forward beyond 10 mm by BSSRO. Genioplasty was performed based on the need of patients' profile. All patients ware followed up for (20.88±3.27) months postoperatively. The data was analyzed with SAS 8.02 software package. RESULTS:According to stanford criteria: AHI<20 and drop to≥50%, the success rate was 93.75%. The patients’ maxilla moved forward by (6.91±1.68) mm,anteriorly raised by (4.13±0.85) mm; the mandible advanced (11.03±1.32) mm. Nine cases underwent genioplasty and the chin was advanced by (9.67±2.00) mm. All patients feel well and OSAHS symptoms disappeared or remarkably improved. The patients’ AHI was 61.59±15.78 preoperatively, the postoperative AHI was 10.04±7.33 (P<0.0001). The LSAT was (72.13±9.63)% preoperatively, the postoperative LSAT was (87.31±4.30)% (P<0.0001). The SNA was (81.32±4.03)° preoperatively, the postoperative SNA was (87.18±3.70)°(P=0.0002);SNB was (72.56±3.99)° preoperatively, and (80.08±3.40)° postoperatively(P<0.0001). MP-H was (26.25±3.49) mm preoperatively, and (21.61±4.04) mm postoperatively (P=0.0016). PASmin was (5.94±1.02) mm preoperatively, and (9.11±2.17) mm postoperatively (P<0.0001). There were no dysphagia or VPI, all patients had good occlusion and no visible deformities were noted. CONCLUSIONS:Bimaxillary substantial advancement and anticlockwise rotation is effective and stable for severe OSAHS patients to advance their maxilla and mandible anticlockwise.

Key words: Severe OSAHS, Bimaxillary anticlockwise rotation and substantial advancement, Q-UPPP