Obstructive Sleep Apnea Surgery

What Is Obstructive Sleep Apnea Surgery?

Obstructive sleep apnea is a condition where a sleep-induced obstruction of the air passage leads to a reduced and turbulent airflow, resulting in insufficient air exchange and sleep fragmentation. It ranges in severity from mild snoring to periods of complete stopping of breathing causing arousals from sleep, often requiring surgery to correct this problem.

This is commonly seen in:

•  Individuals with excessively receded / small lower jaws
•  People suffering from obesity
•  Older individuals with poor muscle control
•  Individuals taking alcohol or sedatives regularly

Why Obstructive Sleep Apnea Surgery Is Done?

Most mild and moderate cases of obstructive sleep apnea can be treated non-surgically by lifestyle and diet modifications, oral appliances and/or positive pressure air therapy.

Severe and unresponsive cases often require surgery to reposition one or both jaws (corrective jaw surgery or distraction osteogenesis) in order to bring the tongue forward and open the airway. This permanently corrects the airway problem and relieves the life-time dependence on other therapies. You need to consult your sleep physician and/or oral and maxillofacial surgeon to find out if this is the best treatment option for you.

What Obstructive Sleep Apnea Surgery Can / Can’t Do

Can

•  Significantly improve breathing, reduce snoring while sleeping
•  Improve quality of life and make you feel more energetic and fresh
•  Improve cognitive function and memory
•  Increase libido
•  Reduce the risk of accidents during work and travel
•  Reduce risk of complications due to diabetes mellitus and heart disease
•  Correct small or underdeveloped jaws
•  Improve face profile

Can’t

•  Cure pre-existing medical conditions
•  Give you a completely new face

How You Should Prepare For Obstructive Sleep Apnea Surgery?

•  A sleep study is performed before the surgery to determine the severity of the problem
•  Underlying problems like obesity and excessivealcohol intake need to be addressed before proceeding with surgery
•  Obstructive sleep apnea surgery is usually performed when non-surgical methods fail to yield results. Consult a sleep physician to consider these methods before surgery
•  Surgery for obstructive sleep apnea is essentially a corrective jaw surgery, which may change dental relationships. Orthodontic treatment usually proceeds simultaneously with the surgery
•  Jaw repositioning done to correct obstructive sleep apnea changes the face appearance. Your surgeon will be able to predict and plan your new face profile with reasonable accuracy before the surgery. Discuss your
•  Discuss any medical illnesses, if you have, with your doctor
•  Stop smoking for at least 2 weeks before the surgery
•  Get an oral prophylaxis (scaling) 1 week before surgery to improve oral hygiene and surgical outcome

What is the Procedure of Obstructive Sleep Apnea Surgery?

Surgery to correct obstructive sleep apnea could be either of the following two procedures:

1. Maxillo-mandibular advancement

This surgery involves separating the jaw bones from the facial bony architecture and repositioning them in a more forward position. The jaws are then fixed into their new position using sterile titanium miniplates.

This jaw repositioning brings the attached soft palate and tongue forward, pulling them away from the back of the throat, opening the airway. The entire surgery is done from inside the oral cavity with no scars or stitches anywhere on the face.

2. Mandibular Distraction Osteogenesis

This surgery involves giving a small cut in the lower jaw bone and fixing a metallic distractor device, which slowly increases the jaw bone length, bringing it forward. This forward jaw movement brings the attached tissues (including the tongue) forward and pulls them away from the back of the throat, opening the airway.

At our centre, the use of piezosurgery for bone cutting prevents the risk of injury to vital nerves and teeth during surgery, making the entire treatment experience safer and more comfortable for the patient. Also, the fixation plates used are premium quality and steam sterilized to prevent any risk of infection.

The treatment planning done is meticulous and jaw repositioning is planned down to the exact millimeter. At our centre, the use of a simulation surgery software during planning allows the patient to be an integral part of the treatment plan and accurately predict the surgical outcome.

Recovery After Obstructive Sleep Apnea Surgery?

•  The surgery may require a period of hospitalization up to 2-3 days
•  Mild facial swelling may be seen for up to 4 weeks days after the procedure
•  A period of jaw closure (intermaxillary fixation) may be required for up to 2 weeks in some cases
•  Solid foods and heavy exercise are to be avoided for up to 4 weeks days after the surgery
•  Regular saline rinses are advised to maintain wound hygiene
•  In case jaw distraction osteogenesis is performed, a second surgery is required after 12 weeks for device removal
•  You may experience some transient numbness of the lip and nasal stuffiness in some cases

Risk involved in Obstructive Sleep Apnea Surgery?

If not performed by an expert, it may result in:

•  Relapse
•  TMJ pain
•  Permanent numbness of the lower lip
•  Damage to teeth
•  Wound infection
•  Distractor device loosening