Twenty-three patients with obstructive sleep apnea syndrome (OSAS) documented by polysomnography underwent maxillomandibular advancement via Le Fort I, and sagittal ramus split osteotomies followed by rigid fixation with miniplates and bicortical screws. Partial turbinectomies and septal reconstruction were simultaneously performed. Pre- and post-operative cephalometric radiographs were analyzed by computer. Hyoid position and posterior airway space changes did not correlate with clinical success. The surgical success (respiratory disturbance index less than 10) with maxillomandibular advancement was 65%. The total desaturations below 90% greatly decreased. Ninety-six percent of patients were subjectively and objectively improved.