Sleep apnea (also called obstructive sleep apnea or OSA) is a sleep disorder with potentially serious consequences. People with OSA can stop breathing multiple times during the night, causing them to wake abruptly and resulting in chronic sleep deprivation (it’s hard on the bed partner, too). OSA has been linked with obesity, diabetes, heart disease and high blood pressure, so it’s important to treat this condition. Here’s the lowdown on sleep apnea and chin augmentation surgery from Oral and Maxillofacial Surgery of New York.
Sleep Apnea: The Basics
Sleep apnea can result from your anatomy or other physical conditions or be caused by a malfunction in area of the brain that controls breathing. The most typical symptoms of OSA are loud snoring and abruptly waking up multiple times in the night. Some people actually stop breathing completely and wake thrashing or gasping for air.
Who Has Sleep Apnea?
Older people and those who are overweight are more prone to sleep apnea, but it can also occur in children who have enlarged tonsils. Small airways or airways that are congested due to allergies or other conditions may increase the risk of sleep apnea. People who have receding chins seem to be more likely to develop OSA, probably because the anatomical structures in the throat make the airway passage narrow. Although both men and women may develop sleep apnea, the condition is more common in men.
Sleep Apnea: Nonsurgical Treatment
For mild sleep apnea, sometimes simple changes like sleeping on your side can solve the problem. Use a pillow or sew a tennis ball into the back of your nightwear to keep you from turning on your back. Some patients improve when they wear a dental appliance called a mandibular advancement splint, which helps to keep the jaw thrust forward during sleep. Moderate to severe sleep apnea is usually treated with a machine called a CPAP (continuous positive airway pressure). A CPAP consist of a mask or other device that fits over the mouth and nose; the patient wears it while sleeping. The increased pressure keeps the airway open. Many patients don’t like the mask, however, and look for other options.
Chin Augmentation for Sleep Apnea
Chin augmentation (one of several types of orthognathic or jaw surgery) is used to change the shape of the jaw. The bone is cut and moved into position, then held in place with metal implants to which bone grafts may or may not be added. Moving the jaw opens up the space through which the airway passes, which makes the tissues less likely to collapse and close the airway. If bone grafts are necessary, the patient’s own bone is used whenever possible, although donor bone is also available. The surgery also changes the shape of the jaw and can improve the patient’s appearance, although that is not its primary purpose.
Who is a Good Candidate for Chin Augmentation?
Like any surgery, chin augmentation is most likely to be successful in patients who are in good general health. It is also more successful in patients age 50 or younger and in those who have a body mass index (BMI) of less than 30. The upper limit of normal for a BMI is 24.9. Ideally, the patient will not have previously had upper airway surgery. Chin augmentation is often most successful in those who have moderately severe sleep apnea. Sometimes patients still need other sleep apnea treatment strategies for best effect.
What’s a Chin Augmentation Procedure Like?
After the administration of general anesthetic, the surgeon makes an incision inside the mouth along the lower gum – a procedure called an osteotomy. The jaw bone is cut in two places and repositioned. Metal implants made of a titanium alloy are placed to hold the bone in its new position and fastened with wires or screws. If necessary, the surgeon will also place a bone graft in the gap between the bones. Most chin augmentation surgeries take about three or four hours. Once the implants are in place, the surgeon sews the incisions closed. The surgery typically takes place in a hospital or outpatient surgery center. Some patients may need to remain in the hospital for a day or two after they recover from the anesthetic.
What About Aftercare and Recovery?
In most cases, the jaw is stabilized and it is not necessary to wire the jaw in position. Small rubber bands and/or braces may be used to keep the implant in place while it heals. You’ll use a mouthwash for oral hygiene at first but eventually will be able to floss and brush as you always do. You will not be able to chew four about four weeks and will need a liquid or pureed diet. Most people return to their normal activities within a few weeks – with the possible exception of vigorous exercise.
Who Can Perform A Chin Augmentation Procedure?
Surgeons who have special training perform chin augmentations and other orthognathic procedures. Maxillofacial surgeons, ENT surgeons (otolaryngologists) and facial plastic surgeons all receive the necessary training, either as part of their basic training or in extended training programs called fellowships. You should confirm that the surgeon has the necessary training and experience before you schedule a surgery. Experience is particularly important, as surgical skill improves when a doctor performs a high number of procedures. Dr. Jamali is unique in this respect as he was originally trained as a dentist before going back to school to train in maxillofacial surgery.
If you have sleep apnea, it can cause many negative health effects. Sometimes orthognathic surgery is really the best solution. Please contact us at Oral and Maxillofacial Surgery of New York for an assessment to see if chin augmentation is a good solution to your sleep apnea problems.