SLEEP ASSESSMENTA lot of people make fun of people who snore, but chronic snoring is no laughing matter, especially if comes from obstructive sleep apnea (OSA). This condition may be treated by medical intervention including surgical treatment. OSA can be a result of one’s upper airway being obstructed because of excess tissue, enlarged tonsils, or having a big tongue or muscles in the airway that collapse while you sleep.
This collapse causes the brain’s impulses to nudge you awake enough to get you to resume breathing, and this cycle can go on all night. If this is happening to you, you are likely experiencing sleep deprivation and other health issues ranging from daytime fatigue, depression, and chronic headaches. Typically, sleep apnea presents as experiencing more than 30 “apneas” (or breathing pauses) during a normal seven-hour sleep cycle. This is common for people with mild or moderate sleep apnea, while severe sleep apnea can happen up to 500 times in one night!
Treating OSA depends on how extreme your condition is. For many people, relief can come from behavior modification, wearing an oral appliance, or using a special device like a C-PAP (Continuous Positive Airway Pressure) or Bi-PAP (Bi-level) machine to keep your throat open while you sleep. However, for those with severe sleep apnea, orthognathic/jaw surgery can often help by surgically shifting the maxilla as well as the upper and lower jaws for optimal alignment.
Possible Sleep Apnea Surgeries
- Genioglossus Advancement (GGA): This surgical approach opens the upper airway by tightening the front tongue tendon to lessen the tongue displacement in the throat.
- Hyoid Suspension: This involves the hyoid bone and its muscle attachments to the tongue and airway. They are pulled forward to increase the airway size and improve airway stability behind and below the base of the tongue.
- Uvulopalatopharyngoplasty (UPPP): By partially removing your uvula, we can shorten and stiffen your soft palate and lessen its edge.
- Orthognathic/jaw surgery for OSA: This maxillomandibular advancement has a 90% success rate in lowering the Hypopnoea Index (AHI) levels for those with severe sleep apnea. It shifts the upper (maxilla) and lower (mandible) jaws forward to create a larger airway for optimal breathing.
Orthognathic Surgery Fixes the Following
- Problems chewing or biting food
- Problems swallowing
- Persistent jaw or jaw joint (TMJ) pain and headaches
- Premature wear and tear of tooth enamel
- Having an open bite when the mouth is closed
- An unbalanced facial symmetry from the front or side profile
- Have a facial injury or birth defect
- A receding chin
- A protruding jaw
- Can’t make the lips come together without effort
- -Persistent mouth breathing and dry mouth
- Sleep apnea and snoring
Orthognathic Surgery
If you have been cleared to have orthognathic surgery for sleep apnea, you can expect the following. First, your surgery will be done in an operating theatre under general anesthesia. Your oral surgery will be done by a maxillofacial surgeon who is also working with an orthodontist to ensure optimal alignment of your jaws and teeth post-surgery. This will be accomplished with the help of dental X-rays, photos along with models of your teeth. The surgical incisions are all made inside your mouth. Your upper and lower jaws will be freed using special instruments and then moved together with titanium plates and screws that securely hold your jaws in the proper position. You might also have your jaw bones restructured, realigned, added to or removed if needed.
Aftercare
While your jaws are not typically wired together, rubber bands may be placed to help keep your bite stable while the surgical site heals. You will want to follow your Post-surgery care instructions along with any follow-ups, including sticking to a soft diet for four to six weeks.
If you have obstructive sleep apnea, we hope this information about orthognathic surgery is helpful. There are a variety of treatments available depending on the severity of your condition. We welcome your questions or concerns about your sleep apnea. Don’t hesitate to give us a call today!