Q: I have had two operations in dealing with my sleep apnea . The operations were done at the University of Miami / Jackson Memorial Hospital , the only place for such an operation at this time. I previously had surgery , and it is much more painful than the mandibular advancement. My opinion is that it spread my airways, but there were other ” bottlenecks ” in my respiratory system surgery did not address . I had a jaw advancement for many years to correct an overbite , but none of these operations cured my sleep apnea . Is there anything I can do to fix sleep apnea , other than more invasive procedures for mandibular advancement?
A: Surgery is an option for the treatment of snoring, along with sleep apnea oral appliances such as lower advancement splint and others. You may need a mandibular advancement device. Surgery should be an option of last resort, reserved for those with the most problems. Because it is more involved than other procedures, jaw advancement surgery is usually performed only in patients who have not responded to other treatments. In moderate to severe cases of mandibular advancement, a jaw lengthening device or nasal continuous positive airway pressure ( CPAP ) are usually prescribed.
What is jaw advancement surgery ?
Mandibular upper advancement surgery is surgery to correct certain face or throat obstructions that contribute to sleep apnea. Lower jaw surgery is done to correct the imperfections of the lower jaw ( mandible ) , which may be too small or too large.
Surgery May be called maxillomandibular advancement or bimaxillary advancement ( if both jaws moved forward ) . Jaw advancement surgery increases breathing space in the throat , because the structures that surround the throat effectively are connected to the jaw.
There are several different surgeries are performed to treat sleep apnea . These include adenoidectomy , tonsilectomy , soft palate surgery and jaw – maxillilo progression (usually curative ) .
Orthognathic surgery corrects jaw and face conditions related to structure , growth, sleep apnea , TMJ disorders , and malocclusion problems, skeletal deformities, or other orthodontic problems that can not be easily treated with braces . Orthognathic surgery is often needed after reconstruction of cleft palate or other major craniofacial anomalies.
Mandibular upper advancement surgery
Maxillomandibular Advancement (MMA ) or orthognathic surgery is also sometimes called bimaxillary Advancement ( Bi – Max) , or Maxillomandibular osteotomy ( MMO ) , or Sleep operation surgery that moves the upper jaw ( maxilla ) and lower jaw ( mandible ) forward .
Cost of surgery
Depending on the mandibular advancement surgery needed, the cost of treatment ranges from $ 3,000 ( soft palate reduction ) to $ 50,000 ( for full orthognathic surgery. ) Lower cost surgeries will be covered by most dental insurance plans.
Risks and recovery from jaw advancement surgery
Mandibular advancement surgery is an invasive dental practice to correct irregularities face or throat obstructions that contribute to sleep apnea. Maxillomandibular operations progress can be very effective , but this method has a more significant risk and recovery compared to other surgical treatment options. However , the procedure is often used for other treatments ( nasal surgery, tonsillectomy , Uvulopalatopharyngoplasty , tongue reduction surgery ) have failed .
Recovery time from jaw advancement surgery takes 3-4 weeks. If surgical jaw fracture is required, the recovery time of the jaw advancement takes no less than 2-3 months and requires wearing chaps hardware to hold the mandible in place.
What Happens During Mandibular Advancement Surgery ?
Orthognathic surgery is performed either an oral and maxillofacial surgeon in collaboration with an orthodontist .
Maxillo – mandibular advancement (MMA ) is a procedure in which both the upper and lower jaw are surgically moved forward . Mandibular advancement (MMA ) moves the upper and lower jaw . They are surgically broken (very carefully , of course) , and then moved forward to create more space in the airway .
This type of surgery allows for the placement of bone screws or plates .
Currently , maxillomandibular advancement surgery is often performed together with tongue advancement . Tongue advancement pulls the tongue forward in a way that reduces the amount of tongue blockage during sleep.
Post – op after jaw surgery
Diet is very important after surgery to accelerate the healing process. After orthognathic surgery, patients are often required to fully comply with a liquid diet .
Mandibular Advancement Devices Vs. surgery
There are mandibular advancement devices that patients can wear on their upper and lower teeth. The mandibular advancement device helps in directing the jaw and tongue in the front and successfully raises the soft palate and keeps the airways clear , which could lead to snoring . Other treatments include CPAP , lower advancement devices and breathing – Rite strips that are all non-invasive .
There are two types of sleep apnea dental devices : lower advancement appliances ( By repositioning the lower jaw and tongue , oral appliance keeps the airway and prevents snoring and apnea events ) and tongue retaining device ( for his position in the front position of the tongue ) .
Surgery is another option for the treatment of snoring ( primjericeuvulopalatopharyngoplasty or Uvulopalatoplasty ) dental appliances such as lower progress splint others . SleepPro advancement splints can completely remove the interference itself. Stop snoring mouthpieces are classified as mandibular advancement devices , which studies show can be more effective than surgery for normalizing sleep and eliminating snoring.
Side effects of oral surgery
Operations such as mandibular advancement are highly invasive , and there are risks of adverse side effects . Every surgery has a risk of complications , failure, etc. It is especially made dental appliances such as lower progress splint , which advance the lower jaw slightly and thereby pulls the tongue forward, vs. mandibular advancement surgery that are more effective in curing snoring.