What kind of jaw chirurgical procedure would you recommend to treat Severe Sleep Apnea Syndrome? (Photos)

Patient diagnosed with severe SAOS, treated with CPAP but with poor adjustment to the therapy. Already underwent adenoidectomy, tonsillectomy, uvulopalatoplasty, laparoscopic sleeve gastrectomy, lost 30kg, and now have a IMC 24. Become highly intolerant to using CPAP because of stomach pain caused by air distention. Can jaw chirurgical procedure be the ultimate way to treat the severe SAOS? Please rate of success and esthetic eventual benefits?

Doctor Answers 5

OSA and jaw surgery

If you notice your lower jaw is moderately small. You should have orthodontic treatment to create an overbite and then bring the lower jaw forward about 8-10mm forward. At the same time, chin should move forward as well. The surgeon should keep in mind the aesthetics and sleep apnea correction at the same time.

New York Oral & Maxillofacial Surgeon
4.8 out of 5 stars 17 reviews

Small chin with OSA

Thanks for your question- 

The problem with a small jaw is that your tongue is attached to your jaw bone. So if the chin portion is set back- the tongue will also be set back and can block the airway... especially when you sleep. 

I would highly recommend an oral appliance to begin with. This is a mouthpiece that will gently position your jaw bone anteriorly and thus draw your tongue base anteriorly as well. If that doesn't work- I'd recommend other procedures such as tongue base suspension or hyoid bone repositioning before you undergo a maxillomandibular advancement which is a very large surgery that carries a relatively high risk rate... If all else fails the MMA procedure is very beneficial and OSA is a very dangerous condition.

It's great that your taking your care seriously, lastly, you'll aways want to have sleep studies and ask your MD to interpret the results to you so that you can fully understand what's going on. 

Thanks for your question!

Dr. Robb

Philip K. Robb Jr., MD
Evans Otolaryngologist
5.0 out of 5 stars 15 reviews

Severe Sleep Apnea

In more complex cases, the bones of the upper
and lower jaw may be repositioned to increase the size of the airway
(orthographic surgery). This procedure is done in the hospital under general
anesthesia and requires a one to two day overnight stay in the hospital.

OSA is a very serious condition that needs
careful attention and treatment. Most major medical plans offer coverage for
diagnosis and treatment.

John Frattellone, DMD
Red Bank Dentist

Jaw surgery and sleep apnea

From your profile picture, it does look like your lower jaw is recessed and this may be contributing to your sleep apnea.  Before you commit to jaw surgery, I would recommend an oral appliance.  These are small devices that can hold your lower jaw into a more anterior position and opening your airway.  If this is successful, you may avoid another surgery all together.Best of LuckDr Rodman

Regina Rodman, MD
Houston Facial Plastic Surgeon
5.0 out of 5 stars 11 reviews

Mandibular Advancement Device should be considered befor jaw surgery

Surgery should be considered a last result. Oral appliance therapy has a high success rate (I have treated MANY severe cases this way).  Seek a Dr from the AADSM or ABDSM website. 

Lance Timmerman, DMD, MAGD
Seattle Dentist
4.3 out of 5 stars 6 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.