Underdevelopment of craniofacial region can be accompanied by small skeletal framework, disproportion between structures, and narrowed pharyngeal airway. Segmental Maxillomandibular Rotational Advancement (SMMRA) is designed specifically for Far-East Asian OSA patients with underdeveloped maxillomandibular skeleton, featured by narrow maxilla with crowded upper dental arch, high mandibular plane angle, mandibular retrognathism, recessive chin and a generally narrowed pharyngeal airway. SMMRA advances maxilla by two segments, counterclockwise rotates the maxillomandibular complex to improve the mandibular plane angle, advance the mandible to the optimal extent, and forward the anterior inferior mandible including chin and genioglossus tubercle. The surgery may normalize the airway, facial skeleton, occlusion, and facial aesthetics at the same time.

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