Mandibular advancement surgery also referred to as jawline surgery or bi-maxillary surgery is a surgery done on the jaw where the lower jaw (mandible) alone or with upper jaw (Maxilla) are moved forward thus enlarging the pharyngeal space in the palate and tongues sections. This helps to prevent the collapse of the pharyngeal.
Mandibular advancement surgery for apnea is a bit complex but is one of the best ways of curing sleep apnea in addition to snoring. However the mandibular advancement surgery cost is very prohibitive. Most people also wonder about the recovery period after the surgery.
Mandibular advancement surgery for apnea is always done if the other methods available are not offering adequate relief. These other method include for example mandibular advancement devices, tongue retaining devices and Continuous positive airway pressure (CPAP). It is also useful for people with severe jaw malformations as the first line treatment method or for people with severe apnea.
Sleeping respiratory disturbance (Apnea-Hypopnea) index (AHI) is the measure used to classify one as normal or has moderate or severe apnea. Moderate and severe apnea may require mandibular advancement surgery to correct. Normal persons have AHI of less than 5 per hour. Mild sleep apnea is having AHI of between 5 and 15 per hour.
JAWLINE/ MANDIBULAR ADVANCEMENT SURGERY
Most of the people worry about mandibular advancement surgery recovery and cost. The surgery increases the space behind the soft palate and tongue. This way the tongue and the soft palate cannot collapse closing the breathing passages. Currently, the tongue is also advanced to ensure maximum benefits. This is the ultimate solution but should be used if the other treatment methods fail. All the other methods should at least be used for 3 months before going for surgery to test their efficacy. Surgery enlarges the nasal /and mouth breathing passages.
Mandibular advancement surgery recovery
Since mandibular advancement surgery is an invasive dental procedure the recovery from jaw advancement surgery is not very long if jaw fracture is not required. It takes to 4 weeks to recover in that case and 2 to 3 months to recover if a jaw fracture was done. This two to three weeks requires one to wear chaps hardware to keep the lower jaw in position. The mandibular advancement surgery recovery period requires the client to be strict on the liquid diet as advised. To aid in the recovery the following are very important:
- Pain Killers
- A Waterpik Flosser. Used to remove food particles from your teeth because you can’t brush your teeth normally
- A blender and Juicer
Mandibular advancement surgery cost
The Mandibular advancement surgery costs range from $3000 to $120,000. This depends on the type of surgery the person suffering from sleep apnea requires. Soft palate reduction costs are the lowest and having a full mandibular advancement surgery costs are higher. Mandibular advancement surgery costs are mostly covered by insurance covers. Thus if other methods fail it should be considered.
Mandibular advancement surgery before and after
Mandibular advancement surgery is a quite effective method of treating sleep apnea and production of loud snoring sounds. However, like most surgeries, MAS also has its risks. The mandibular advancement surgery being very invasive can have complications or failure. It is also a very painful process. Mandibular advancement surgery can also be done on aesthetic basis or to ensure the person has the right teeth orientation. Mandibular advancement surgery before and after has shown tremendous improvement in the way you speak, the way you eat and the way you look too.
OTHER SURGICAL TREATMENTS OF OBSTRUCTIVE SLEEP APNEA
Tissue removal/ Uvulopalatopharyngoplasty.
This involves removal of tissues from the back of the mouth and upper part of the throat. It may also include the removal of tonsils and adenoids. However, even though it is quite effective it is not as effective as CPAP. For people who are not comfortable with a CPAP a radiofrequency ablation can be done to remove the tissues.
In this mini-procedure, plastic rods are inserted into the soft palate. This way the soft palate does not collapse to the air passages.
This is a procedure that creates a new airway. However, this is the last result if all the methods fail to work and the apnea can cause death or disability. This passage is only used at night but closed during the day.
DIAGNOSIS OF SLEEP APNEA
Sleep apnea is a disease that reduces the quality of sleep and life to the individual. To diagnose sleep apnea one has to check the symptoms below:
- Chronic fatigue and drowsiness during the day
- Waking up frequently at night with shortness of breath
- Snoring loudly with moments of silence
- Headaches in the morning
- Having moments of no breathing as witnessed by other people
- Sore throats and dry mouths when you wake up
- Insomnia especially difficulty in staying asleep
- Sleepiness during the day (Hypersomnia)
- Decreased attention
- Being irritable often
If the symptoms listed above especially snoring, shortness of air and chronic fatigue/ drowsiness are very common then you need to see a doctor. This is because they may also be caused by other sleeping disorders like narcolepsy.
What are the types of sleep apnea?
Causes of obstructive sleep apnea:
It is the most common sleep apnea disorders. It occurs when the muscles that support the soft palate relax. When these muscles which are found at the back of your throat relax the breathing passages narrows or closes leading to decreased flow of air into the lungs. This causes the brain to sense lower concentration of oxygen in the blood thus waking you up. The short episode of waking up may not be recalled by the person suffering from sleep apnea. The common signs are producing loud snoring sounds, gasping for air, frequent waking up and the other apnea symptoms above. The risk factors for obstructive sleep apnea include being overweight, thick neck circumference, the male gender, old age, inherited narrow airways, family history of the disease, use of sedatives, smoking, nasal congestion, use of tranquilizers and alcohol intake. Sleeping on the back increases the incidences of sleep apnea.
Causes of central sleep apnea.
This apnea is less common as compared to obstructive sleep apnea. It is caused by lack of signal transmission from the brain to the throat muscles during sleep. Therefore the body does not make an effort to breathe for a few moments. The risk factors for central sleep apnea include age, heart disorders, stroke and use of narcotic pain killers.
Causes of Complex sleep apnea syndrome
Referred also as treatment-emergent central sleep apnea. It is a combination of both central sleep apnea and obstructive sleep apnea. Therefore it has successive period of loud snoring sounds and lack of breathing.
COMPLICATIONS OF OBSTRUCTIVE SLEEP APNEA
Day time fatigue: Obstructive sleep apnea is the major cause of daytime fatigue. This can lead to accidents at places of work or while driving. The problem also increases the incidences of quick temper and feeling of depression.
High blood pressure
Sleep apnea causes drop in blood oxygen levels. This drop causes the heart to overwork thus leading to high blood pressure. This also causes a strain in the cardiovascular system.
Sleep apnea if very common can also lead to other heart problems in the long run. The heart problems include stroke, heart attack and abnormal heartbeats. OSA may also cause metabolic syndrome.
Type 2 diabetes
Sleep apnea is associated with increase in insulin resistance leading to diabetes. Type 2 diabetes is harder to treat also if one has sleep apnea.
Surgery and medication complications
If you have sleep apnea, it is recommended that you inform the physician before any surgery. This is because OSA causes periods of breathing problems. When OSA is combined with general anesthesia or some medications can lead to complications.
Liver problems/ nonalcoholic fatty liver disease
OSA can cause liver scarring. This always manifests with abnormal results on liver function tests.
Insomnia and sleep deprivation in partners
When your partner produces loud snoring sounds and then stops breathing can be a major cause of psychological torture to you. This always causes spouses to either sleep in different rooms.
Lifestyle remedies for Sleep apnea
- Losing weight
- Avoiding alcohol, tranquilizers and OTC sleeping pills
- Sleeping on the side or abdomen.
- Use of saline nasal sprays to open nasal passages at night
- Quit smoking
Maxillary advancement surgery is a delicate, intrusive and painful procedure that should be done if all the other methods are not giving you the required relief from snoring and sleep apnea. One can try pure sleep mouthpiece , the best mouth piece that gives relief in most of the OSA and snoring people. In addition there are several other sleeping aids that can offer relief.