Background and objectives: The prevalence of the obstructive sleep apnea syndrome (OSAS) is about 4–6% in men and 2–4% in women. It has been calculated that mortality among people sick with severe OSAS is 40% within an eight-year period. Continuous positive airway pressure (CPAP) is the elective treatment for this disease, but it has very low therapeutic adherence (21–50% within 2 years) derived from the discomfort it causes.

Methods: The Sleep Unit from Clínica Universidad de Navarra has methodically diagnosed and treated, both medically and surgically, people suspected for OSAS since the year 2006. Between the years 2006 and 2012, 2376 patients underwent complete overnight polysomnography. 97 of them accepted surgical procedures included in phase 1 of Stanford protocol, 21 patients were treated with bimaxilar advancement.

Results: 87% of the patient who underwent surgical treatment used CPAP prior surgical procedures and during hospitalization. A healing rate of 86% was achieved in those patients who underwent bimaxilar advancement. An increase in preliminar airway volume is presented as a predictive factor of treatment success.

Conclusions: A correct surgical indication in patients who do not tolerate CPAP, can improve symptoms and the parameters analyzed in polysomnographic studies, as well as in 3D images.