@article {Lagan{\`a}P38, author = {Francesco Lagan{\`a} and Alessandra Ferrari and Alessia Spinzia and Mario Ziola}, title = {Gnato-oral-pharyngeal normalisation: new concept leading maxillo-mandibular reconstructive surgery in OSAS}, volume = {3}, number = {suppl 1}, elocation-id = {P38}, year = {2017}, doi = {10.1183/23120541.sleepandbreathing-2017.P38}, publisher = {European Respiratory Society}, abstract = {The maxillo-mandibular osteotomy with advancement treatments (telegnathic maxillo-mandibular advancement - Princell et all) have proven over the years extremely effectiveness in the OSA treatment, highlighting the primary role of extrapharyngeal surgery than intrapharyngeal.We present our experience, based on 40 patients among in which we highlight a series of 10 patients, illustrating a therapeutic process that has led us to define the gnato- oral- pharyngeal normalization concept, meaning in the need of balance between different elements that define the volume of the upper airway: individual dental occlusion, soft tissue and maxillo-mandibular skeletal.A cases serie of 40 patients were treated with telegnathic maxillo-mandibular advancement. For 10 of these patients has been planned and executed a treatment according to the gnato-oral-pharyngeal normalization concept which provides in a presurgical orthodontic preparation followed by the osteotomy surgery.The results are encouraging: average of AHI 6,3{\textpm}3,6 and average of Epworth sleepiness scale 1,8{\textpm}1,8 confirm the healing (AHI\<10) of almost all the treated cases.The osteotomy surgery success shows how the lack of dynamic equilibrium between the soft tissue and the air duct limited by the maxillo-mandibular skeletal structure, which offers a rigid support to the upper airways, represent the main etiologic factor in OSAS .Patients undergoing gnato-oral-pharyngeal normalization in addition to achieving a clinical healing (AHI \<10) had less problems with postoperative occlusion and greater satisfaction from an aesthetic point of view, thanks to the best anthropometric balance obtained with the orthodontic-surgical programming .}, URL = {https://openres.ersjournals.com/content/3/suppl_1/P38}, eprint = {https://openres.ersjournals.com/content}, journal = {ERJ Open Research} }