Further bias is introduced with the

Further bias is introduced with the use of divergent criteria for surgical success. Therefore, in clinical practice surgical interventions for OSA are usually reserved for patients who are “nonresponsive” or “nonadherent” to noninvasive therapies such as CPAP or oral appliances. Exceptions to this “rule” are patients characterized by a severe malocclusion, retrognathia, or a bimaxillary retrusion. In these patients, MMA surgery will not only be likely to correct their OSA, it will also result in a more harmonic dentofacial composition. This subgroup of patients may therefore be offered MMA surgery as a primary treatment. In addition, young patients that wish for a more “permanent” solution for their OSA instead of a lifelong treatment with noninvasive therapies like CPAP or an oral appliance are generally also good candidates for MMA surgery.