Mannarino and colleagues published in this journal an interesting review article on the obstructive sleep apnea syndrome (OSAS) . They enlisted several therapeutic options of this syndrome that, if severe and left untreated, has a 4-year mortality rate of 20% . They stated that surgical treatments remain controversial, mainly because controlled studies and standardized criteria to define surgical efficacy are lacking. We believe that these considerations are debatable regarding the maxillo-mandibular advancement (MMA) procedure, which nowadays is the most powerful therapeutic option to treat patients with severe forms of OSAS, with a strong rationale that supports indications and results.
