Surgical Treatment of a Patient with Obstructive Sleep Apnea Syndrome Associated with Temporomandibular Joint Destruction by Rheumatoid Arthritis

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Craniomandibular abnormalities, especially retrognathism, have been reported in association with sleep apnea syndrome.1 Adult acquired micrognathia occurs rarely in the course of rheumatoid arthritis and may result in sleep apnea syndrome.2 Furthermore, sleep apnea due to brainstem compression by the odontoid peg has been observed in rheumatoid arthritis.3

We have previously reported a patient who developed severe sleepiness and sleep apnea in association with adult acquired retrognathia as a result of rheumatoid arthritis.4 The patient was improved by nasal continuous positive airway pressure. We now report the success of bilateral ramal and temporomandibular joint reconstruction to cure the disease.

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