Sleep apnea treated with orthognathic surgery
Written by:What is orthognathic surgery?
Orthognathic surgery or surgery of the facial skeleton is a set of techniques that serve to mobilize the different bone elements that make up the face, jaw, maxilla, chin, cheekbones, and place them in the ideal situation.
Who needs orthognathic surgery?
Orthognathic surgery is indicated, on the one hand, for those patients who have an alteration of the skeletal elements that make up the face that cause an aesthetic deformity, therefore most of our patients who seek orthognathic surgery do so for a motivation esthetic. There is also another part of patients in whom the main problem is an alteration in the occlusion of the teeth, when the jaw or the jaw are badly placed the teeth do not fit well and the first reason for consultation or what bothers the patient is that the teeth do not fit. They come to us and then we propose a joint treatment in which an orthodontist is in charge of ordering the teeth and later we take care of moving the bones and placing them in their place. It is considered that a large number of the population could eventually benefit from orthognathic surgery because it has some type of alteration, by excess or defect, in the size and shape of the bones of the face.
Is orthognathic surgery a definitive solution for sleep apnea?
Sleep apnea is a problem that affects both men and women, it is a major problem, and it basically consists of patients suffering from it having an airway where they breathe that collapses at night when they are lying down and then the air does not pass. It is a severe problem that, in the most aggressive forms, conditions hypertension, cardiovascular problems and even death. These patients need to be connected for life, at night, to a mask that supplies them with oxygen at high pressure and keeps the airways open. There is a significant percentage of these patients in whom the cause of this collapse of the airway is an alteration in the position of the maxilla and / or jaw, mainly of the jaw. In these cases, orthognathic surgery, by repositioning the maxilla and mandible forward, widens and increases the volume of that airway and allows that air flow to normalize.. Patients suffering from sleep apnea who undergo orthognathic surgery manage to heal completely and disconnect from the famous Cpap machine that they call the infernal machine.
What are the advances that have occurred in orthognathic surgery?
The most important advances in orthognathic surgery are on the one hand in diagnosis and planning. We have developed a virtual, three-dimensional planning platform in the maxillofacial institute, which allows us to plan three-dimensionally or three-dimensionally reproduce the surgery that we will perform on the patient after a scan of the patient's face.. This gives us a level of accuracy of tenths of a millimeter that also makes the surgery much shorter and therefore the recovery much greater. The research of this platform and its validation, which we have developed over the last 3 years, will be published shortly in the international oral and maxillofacial surgery journal. The other great advance is the development of minimally invasive surgery techniques. Now we are able, through small incisions in the gum, made inside the mouth to reach the bones and making small cuts in the bones, mobilize them and place them in the position that we have previously designed with the three-dimensional planning. These surgeries that typically lasted 4 or 5 hours now last between half an hour and an hour and a half and that allows the patient the next day to go home.
What type of anesthesia will be used and what is the recovery time of the surgery?
Classically orthognathic surgery is done under general anesthesia and still today in cases where we have to mobilize the maxilla and the jaw, the so-called bimaxillary surgery is still done under general anesthesia.. However, for years we started a protocol whereby the cases in which we only have to operate the jaw are performed or we can perform them under local anesthesia and sedation. They are very short surgeries that last around 30 minutes and the patient arrives, is operated on an outpatient basis and a while after the surgery and can go home. This obviously has a very favorable impact on the patient's recovery and also on the patient's perception of the intensity of the surgery.
