maxillo mandibular advancements

Overcoming Challenge of Condition | Obstructive Sleep Apnea A Life-Changing Journey

The Disturbing Symptoms

One of our recently successfully operated patients who was residing in the USA, before coming to us, struggled with symptoms such as severe snoring and interrupted breathing during sleep for years which had become a constant source of distress for him. He could not sleep properly, coupled with restless nights.

Diagnosis | Obstructive Sleep Apnea

This led him to consult several doctors who recommended X-rays and visits to ENT specialists. After seeking help from various doctors, he was diagnosed with Obstructive Sleep Apnea (OSA), a condition that significantly impacted his quality of life.

Understanding Obstructive Sleep Apnea | Layman’s Guide

In simpler terms, it’s like a temporary pause in breathing that happens repeatedly throughout the night. Imagine trying to take a deep breath, but something is blocking the airflow, causing a momentary halt in breathing.

The key culprit behind OSA is the obstruction of the upper airway, particularly when the muscles at the back of the throat relax excessively during sleep. This relaxation leads to a narrowing or complete closure of the airway, creating a temporary blockage. Just like a traffic jam on a narrow road where the airflow struggles to get through.

One of the hallmark signs of obstructive sleep apnea is loud snoring. The snoring is often accompanied by brief pauses in breathing, sometimes lasting for just a few seconds to more extended periods. These pauses can happen multiple times per hour, severely disrupting the normal sleep cycle.

Why Does It Matter?

People with obstructive sleep apnea often experience excessive daytime sleepiness and feeling constantly fatigued. It is like as if they didn’t get a good night’s sleep even after spending the recommended hours in bed. Untreated, OSA can lead to risks of high blood pressure, stroke, and heart attack, or can cause heart arrhythmias.

layman guide

Impact on Daily Life

The consequences of untreated OSA extended beyond the night. He started experiencing reduced productivity, excessive daytime sleepiness, and persistent fatigue. Further investigations revealed that his condition of OSA resulted from the obstruction of his upper airways due to a small and retruded lower jaw. This condition caused brief pauses in breathing when his airway muscles relaxed during sleep, leading to recurrent awakenings. Because of the severity of his condition, doctors recommended a polysomnography test to know the severity of the condition which came out to be 33( Moderate OSA).

What Is Polysomnography?

To diagnose sleep apnea, we perform an overnight sleep study called a polysomnogram (PSG) in the sleep laboratory. The PSG records your brainwaves, eye movements, muscle tone, breathing patterns, oxygen levels, and other body functions. The information recorded helps to categorize the severity of the condition.

Ignoring The Warning Signs

Despite the initial diagnosis, he hesitated to take precautionary measures. Unfortunately, his condition worsened over time, and his snoring also worsened his next polysomnography score same out to be 90, classifying him with severe obstructive sleep apnea.

Conventional Treatment | CPAP (Continuous Positive Airway Pressure) Machine

The recommended treatment from doctors involved using a CPAP machine a device that delivers continuous positive airway pressure to keep the airway open during sleep. However, the cumbersome nature of the CPAP machine, covering the nose and mouth entirely, proved challenging for him every day.

CPAP machine

Seeking Permanent solutions

He was fed with all the treatments he took in the USA as nothing worked for him and his condition was getting worse day by day. Driven by the desire for a permanent lasting solution, he researched extensively and discovered Dr. Sunil Richardson in India, who is renowned for addressing such Craniofacial and Jaw issues. Convinced that surgery might offer a permanent solution, he decided to travel to India for consultation and treatment.

Upon arrival, Dr. Sunil Richardson meticulously reviewed his scans, reports, and polysomnography results. Understanding the severity of the case, he proposed a solution that was Bijaw surgery, involving a major advancement of both the maxilla as well as mandible. Additionally, genioplasty (chin surgery) was recommended to enhance his facial aesthetics and double chin issues. To ensure accuracy in surgical execution, a comprehensive plan was devised using digital software. A 3D splint was fabricated to guide the precise movements required during the surgery.

Achievement of Immediate Results

The surgery was successfully performed, leading to immediate improvements in his condition. Remarkably, he experienced uninterrupted sleep the very next day, marking a transformative moment in his life. The surgical intervention not only resolved his breathing problems but also provided aesthetic enhancements, including a well-projected chin and an improved jawline. From the very next day of his surgery, all his snoring and sleep issues were gone and he felt so refreshed after getting a good sleep after ages. Post-operative scans also showed that the airway was opened with such huge maxillo- mandibular advancements.

A New Lease on Life

This patient’s journey highlights the transformative power of surgical intervention in cases of severe obstructive sleep apnea. Contrary to conventional treatments like the CPAP machine, Bijaw surgery proved to be a permanent solution, freeing him from the constraints of sleep apnea. With the successful surgery, now he no longer relies on the CPAP machine and has returned to a normal, fulfilling life. He is extremely satisfied with his new face and treatment and is living a better quality of life and also joined back his work in the USA. This success story sets an example that early consultation with Maxillofacial surgeons and surgical interventions can help in resolving such conditions.

Bijaw surgeryThe first image shows blocked airway space whereas post post-surgical Saggital view of CT demonstrates opened-up upper airway space after surgery with maxillo–mandibular advancement.

up upper airway space

snoring sleep issues

severe obstructive sleep apnea


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