Procedure of Obstructive Sleep Apnea Surgery

Obstructive sleep apnea (OSA) is a sleep disorder where while you are asleep, the air passage blockage results in reduced and turbulent airflow, resulting in insufficient oxygen intake and sleep fragmentation. The disorder can be seen in severity from mild snoring to periods of complete obstructed breathing, often causing arousals from sleep throughout the night.

Sleep apnea causes sudden instances of reduced oxygen supply to the brain and other parts of the body, which results in poor sleep quality and daytime drowsiness. People with sleep apnea tend to feel drowsy and have headaches that are difficult to treat.

It is one of the most common types of sleep apnea and is usually found in older people or people who are obese. Surgery for Obstructive Sleep Apnea surgery is a preferred treatment for people suffering from the condition to help relieve the symptoms caused by sleep apnea.

Who can get Obstructive Sleep Apnea?

It is a common and serious disorder mostly found in adults and can also be found in children. While in adults, the most common reason for sleep apnea is excess weight and obesity, in children, it can be enlarged tonsils or adenoids and dental conditions such as a large overbite. Anyone can develop obstructive sleep apnea due to various reasons. Obstructive sleep apnea is commonly seen in:

• People with small or receded lower jaws
• People who are overweight
• Older people with poor muscle control
• People who consume alcohol or sedatives regularly

How do I know if I have Obstructive Sleep Apnea?

Sleep apnea is when your breathing stops and starts while you are sleeping, so it might be hard for you to tell if you have sleep apnea. Do you wake up with a headache in the morning? Feel tired and drowsy due to poor sleep? Has anyone complained that you snore loudly or gasp and choke every night?

If you have any of the following symptoms, you may be suffering from obstructive sleep apnea and should consult a sleep clinic:

• Partner/family complains of you snoring excessively.
• Feeling overly sleepy or tired during the daytime.
• Constantly unable to get a good night’s sleep and wake up fresh in the morning.
• Experience a sudden choking sensation during normal breathing.

Do I need Surgery to treat Obstructive Sleep Apnea?

There are other ways to treat mild and moderate OSA cases, such as non-surgically by bringing changes in lifestyle and making diet modifications, and/or with positive pressure air therapy.

Lifestyle changes

• Lose weight if you are overweight.
• Make a habit of regular exercise.
• If you drink alcohol at all, it should be a moderate quantity. Avoid alcohol several hours before you go to sleep.
• Quit smoking.
• You can use a nasal decongestant or allergy medications.
• Avoid sleeping on your back.
• Don’t take sedative medications like anti-anxiety drugs or sleeping pills.

If these changes to your lifestyle do not work for you or your sleep apnea is moderate to severe, your doctor may suggest other treatments.

Therapies

Positive airway pressure: This therapy includes a machine that delivers air pressure through a piece that fits into your nose or is placed over your nose and mouth while you sleep. It reduces the respiratory events that occur as you sleep, reduces drowsiness, and improves your sleep quality.

However, most severe and unresponsive sleep apnea cases often require Obstructive sleep apnea surgery to reposition one or both jaws to bring the tongue forward and open the airway for smooth airflow. The surgery can be a permanent solution to OSA and eliminate lifetime dependency on lifestyle changes and other therapies. You need to consult your sleep physician and/or oral and maxillofacial surgeon to determine if this is the best treatment option for you.

What happens if you leave Obstructive Sleep Apnea untreated?

Sleep is an essential part of our existence. Sleep allows both the body and brain to recover from daily stress. Leaving sleep apnea untreated implies poor oxygen delivery to the body tissues. It can significantly impact your quality of life and worsen any pre-existing medical conditions. Some adverse effects include:

• Poor cognitive function and memory
• Decreased libido
• Increased risk of accidents due to drowsiness
• Worsening of diabetes mellitus and heart disease
• Increased risk of heart failure and stroke

How should I prepare for the Surgery?

Surgery for Obstructive Sleep Apnea is done in severe and unresponsive cases to reposition one or both jaws, helping relieve the condition. Here is how you can prepare for the Surgery:

• Your doctor will perform a sleep study to analyze the seriousness of the condition prior to surgery.
• Obstructive sleep apnea surgery is performed in mild to severe OSA cases where non-surgical therapies fail to show positive results. Hence, it is essential to consult a sleep physician for other therapies before considering surgery.
• OSA requires corrective jaw surgery, and orthodontic treatment is usually done simultaneously with the Surgery.
• Jaw repositioning surgery performed to correct OSA often changes the patient’s facial appearance. Your surgeon will discuss these changes prior to the surgery.
• It is important to discuss any medical illnesses with your surgeon before the surgery.
• You must avoid smoking for 2 weeks prior to surgery.
• Get oral prophylaxis (scaling) 1 week before Surgery to improve oral hygiene and surgical outcome.

Obstructive Sleep Apnea Surgery Procedure

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

1. Maxillo-mandibular advancement

In this procedure, your surgeon separates the jawbones from the bony facial architecture and repositions them in a forward position. Sterile titanium mini plates are used to fix the jaws into their new position.

This procedure brings the soft palate and tongue forward while pulling them away from the back of the throat and opening the airway for smooth airflow. The entire surgery is performed inside the mouth, which leaves no visible scars on the outside.

2. Mandibular Distraction Osteogenesis

In this surgery, the surgeon makes a small cut in the lower jaw bone and adds a metallic distractor device. This increases the jaw bone length and brings it forward. This leads to bringing the attached tissues and the tongue forward. The tongue is brought forward, which opens the airway.

At our center, 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. We use premium quality fixation plates, which are steam sterilized to prevent any risk of infection.

The surgeon plans the jaw repositioning meticulously down to the exact millimeter. At our center, simulation surgery software during planning allows the patient to be an integral part of the treatment plan and accurately predict the surgical outcome.

Where and by whom should you get OSA Surgery?

Oral and maxillofacial surgeons are trained to perform this type of Surgery. As our in-house board-certified expert Dr. Rajat Gupta says, the surgeon and the center where you get the Surgery are necessary to determine the final result’s quality.

Therefore, you must make sure that the following aspects are satisfied:

• The surgeon
• The center
• The techniques of Surgery

Before getting the Surgery done, get a consultation, and be sure that you want the Surgery to be done.

How long does it take to recover after the Surgery?

It is a straightforward and safe surgical procedure for people with obstructive sleep apnea. Here is how long it will take for the patient to recover after the Surgery:

• After the surgery, the patient might have to stay hospitalized for 2-3 days. After the checkup, and if everything is okay, the patient can go home with a family member.
• Mild facial swelling may be seen for up to 4 weeks after the procedure.
• Intermaxillary fixation or jaw closure may be required for two weeks in a few cases.
• It is advised to avoid any solid food and heavy exercise for four weeks after the surgery.
• Regular saline rinses are advised to maintain wound hygiene and aid in healing for quick recovery.
• Jaw distraction osteogenesis requires a second surgery to be done after 12 weeks to remove the metallic device.
• You may experience some transient numbness of the lip and nasal stuffiness in some cases.

If not performed by a board-certified Oral and Maxillo-facial surgeon, patients may experience the following:

• The condition may relapse, and patients can develop OSA again
• TMJ pain
• Patient’s can experience permanent numbness in the lower lip
• Teeth can be damaged
• The area of the surgery can develop a wound infection
• Loosening of the distractor device

The Surgery does not cure any pre-existing medical conditions, and it cannot give you a completely new face.

Benefits of OSA surgery

Leaving the condition untreated can cause adverse effects in your body, so it is important to seek treatment. Despite the side effects and risks in the Surgery, if performed by an expert, the following are the benefits of the Surgery:

• It significantly improves breathing and reduces snoring while sleeping.
• Surgery improves your quality of life and makes you feel more energetic and fresh.
• It also improves your cognitive function and memory.
• It increases your libido.
• With reduced obstructive sleep apnea symptoms, the risk of accidents during work and travel is also reduced.
• It helps reduce the risk of complications due to diabetes mellitus and heart disease.
• The Surgery corrects small or underdeveloped jaws.

Results of the procedure

After the surgery, the patient gets significantly improved breathing and reduced snoring while sleeping. It reduces the risk of any other health issue and keeps you fresh and energized with improved cognitive function and face profile.

Contact Dr. Sanchaita Kohli for further details

We understand that you might be nervous about getting Obstructive Sleep Apnea treatment. Although we have covered all the necessary queries and doubts that you might have about the procedure, having further doubts is only natural.

Getting any kind of Surgery is personal, and it can be tough to make the decision. This is why you must consult Dr. Sanchaita Kohli for any queries that you may have regarding the procedure. Dr. Sanchaita Kohli is a board-certified Oral and Maxillofacial surgeon who operates from a well-equipped center, RG Aesthetics. She will be pleased to answer all your queries and doubts.