Although oral appliances can greatly benefit many patients with mild to moderate obstructive sleep apnea (OSA), dental devices may not be a sufficient treatment for those with a severe form of the sleep disorder. In these cases, continuous positive air pressure (CPAP) therapy or surgery may be more effective routes for patients to stop snoring, decrease apneas, and get a better night’s rest.
Bimaxillary Advancement Surgery Basics
Until relatively recently, many sleep apnea surgeries have suffered from low rates of efficacy, daunting side effects, and long recovery times. However, in the past few years, more and more surgeons around the country have found success with bimaxillary advancement surgery, also known as maxillomandibular advancement (MMA) surgery.
Unlike sleep apnea surgeries of the past, which in large part cut away parts of the inner mouth and throat in order to increase airflow, bimaxillary advancement surgery takes an innovative approach to the issue of blocked airways. During the procedure, the surgeon moves both the upper and lower jaw forward as much as an inch, opening the airway simply by restructuring the pathway and literally giving patients room to breathe.
Before the surgery. Before the procedure, the OSA patient will meet with a surgeon, anesthesiologist, and orthodontist to make certain that he or she is a good candidate for the surgery and to make sure that their bite is stabilized. The preoperative evaluation includes 3D Cone Beam CT scans and specialized airway and facial skeletal software that allows the medical team to diagnose the obstructive and maximize airflow improvement during the surgery.
During the surgery. The patient is given a general anesthetic while the surgeon makes incisions in the inner mouth, mobilizes the upper and lower jaw, and moves both forward. The jaw is then fixed into place using titanium plates and screws. In some cases, the teeth may be stabilized by braces, arch bars, or rubber bands for several weeks during the healing process.
After the surgery. Full patient recovery can take 8-12 weeks, although the vast majority of our patients spend only one night away from home in a hospital or recovery center and return to work in 7 to 10 days. A liquid diet is required for 3-5 days after the procedure before a soft chewing diet can begin. Swelling and pain are controlled with liquid medications. Most patients report being able to breathe more easily and sleep better immediately after surgery.
Advantages and Disadvantages of Bimaxillary Advancement Surgery
At Surgical Sleep Solutions, over 95 percent of our sleep apnea surgery patients are cured of their OSA symptoms.
Advantages:
While a small minority of patients may still need or prefer the assistance of a CPAP machine or oral device, most have found a permanent solution to their sleep apnea and no longer need to treat their disorder with the help of a device. This is especially good for those who travel for work, those who have difficulty with compliance, and those who suffer side effects from CPAP therapy.
Disadvantages:
Like all surgeries, bimaxillary advancement surgery comes with a small number of risks and the chance of complications. The procedure may be expensive for those without the appropriate health insurance or for those who have difficulty taking paid time off of work. Finally, bimaxillary advancement surgery may not be a good option for those with other health problems or those with very high body max indexes (BMIs).
Sleep Apnea Surgery at Surgical Sleep Solutions
Surgical Sleep Solutions has been perfecting a unique delivery model for bimaxillary advancement surgery for over eleven years and have taken great pleasure in watching our patients begin their new lives without suffering from the symptoms of sleep apnea. We encourage everyone who believes they may be suffering from OSA to speak to their doctor about getting a diagnosis and getting help. You can also take this self evaluation to see if you are at high or low risk as well.
Please note that before surgery we recommend trying CPAP for a minimum of three months.
Contact us for more information or to setup a consultation today.
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