Advice on surgery please

Message

#1 Post by **rachesi** » Tue Jun 23, 2009 12:30 pm

I was wondering whether anybody could give me any advice. I have the classic signs of a mouth breather; with a long, forward neck, a recessed chin, a narrow palate and a lack of cheekbones etc. However, I've had braces and my bite is perfect, so is surgery really needed?

I'm asking because I feel tired everyday, my head is always foggy and I find it hard to concentrate. I can breathe through my nose in the day, but not at night. My doctor says that it is because my nose is blocked, but if I wake up suddenly during the night it seems fine; it certainly isn't blocked enough to make me breathe through my mouth. I find it strange because when I lie down, I can still breathe through my nose, so it must just happen when I fall asleep.

Has anybody else had these symptoms, and if so did surgery cure it? Also, what kind of surgery did you have?

I get the impression that a lot of people on here have the surgery for bite issues, so I was wondering if anybody had had it for other health issues. If I can correct my breathing issues and posture through surgery, I would be happy.

Thanks

#2 Post by **rachesi** » Tue Jun 23, 2009 12:48 pm

Also, does anybody in the UK know if I can be referred by my dentist, as my doctor will only refer me to ENT, which is a waste of time as I've already been.

#3 Post by PJ » Tue Jun 23, 2009 12:49 pm

Have you ever had a sleep study done? The fogginess and lack of concentration could be the result of sleep apnea--very common in mouth breathers, which I used to be before my surgery. I am someone who had the surgery more to cure the sleep apnea, than for any other reason, though closing the open bite certainly helps with function, and it's more aesthetically pleasing--or it will be, once I get my bite perfected and the metal leaves my mouth. If you do have sleep apnea there are other routes you can try besides surgery, so you should first get a study done, then explore all your options--in the event that you do actually have sleep apnea.

#4 Post by **AF104** » Tue Jun 23, 2009 8:46 pm

My surgery was principally for airway insufficiency(non-apneic) and the surgery definitely helped. You said that you've been to an ENT. They can rule out most airway deficits so it doesn't seem that you have anything too serious. It seems weird that they didn't order a sleep study and that you didn't see to it that they did. In regard to this comment: "If I can correct my breathing issues and posture through surgery, I would be happy." There's no absolute indication that surgery will provide significant benefit for those problems. By mentioning a recessed chin and a lack of cheek bones it seems like you really care more about the cosmetic aspect of jaw surgery. Especially since they are NOT classic signs of mouth breathing. Unfortunately, you need significant and objective symptoms for surgery(unless you want to pay the full cost out of pocket). A sleep study would be a good start. If that's normal then you'll probably have to pay the whole cost yourself(and that assumes that the surgeon would even operate on you).

#5 Post by **rachesi** » Wed Jun 24, 2009 1:30 am

Yes perhaps a sleep study would be a good idea. I was under the impression that surgery might help with both posture and breathing, since people seem to have had improvements with both of these things. I can assure you that a recessed chin and flat cheekbones ARE classic signs of mouthbreathing, as many people on here will confirm and many medical journals will confirm.
After reading posts about mouthbreathing, I realised that I had the same symptoms as everyone else, except my bite has been corrected through orthodontics. And yes, to be honest, if there was some kind of cosmetic improvement then I would be pleased, but I am principally concerned with not feeling tired. I wouldn't just have it done to see aesthetic improvement, though. Sorry but I found your post rather rude, to be honest.

#6 Post by **rachesi** » Wed Jun 24, 2009 1:40 am

And sorry, but what is so weird about not ordering a sleep study from my ENT? I only realised that they existed in the past few months anyway, after reading about them on this site. As it is, I shall be going back to an ENT surgeon and I shall ask about the sleep study; hopefully they will grant me one, and I will take it from there. Please don't accuse me of things when you don't know my situation. Thank you.

#7 Post by **AF104** » Wed Jun 24, 2009 5:10 am

I'll elaborate since I wasn't absolutely clear. In regards to this comment "I was under the impression that surgery might help with both posture and breathing, since people seem to have had improvements with both of these things." It MIGHT help. That's basically what I said. "There's no absolute indication" means the same thing. A recessed chin isn't a symptom of mouth breathing. It is a CAUSE of mouth breathing. Receded cheek bones have a negligible effect on the airway(much less so than the jaws). Classic symptoms of mouth breathing are pneumatic gingivitis, dry mouth, bad breath, etc. I didn't suggest you would only have it done for cosmetic reasons. I said it SEEMS like what you're most worried about. I never said there was anything wrong with that either(although a DR. might). In regards to this comment "It seems weird that they didn't order a sleep study and that you didn't see to it that they did." I didn't mean that you should have suggested it in such literal terms. Saying "I feel tired in the morning, can't concentrate, etc." implies the need for a sleep study and would tip a surgeon off to the need for one.

#8 Post by **Audra** » Wed Jun 24, 2009 7:57 am

Have you had your thyroid checked?

#9 Post by **rachesi** » Wed Jun 24, 2009 1:58 pm

Audra wrote:Have you had your thyroid checked?

Hi, yes they've checked my thyroid and they also checked me for diabetes, but both came back clear. I've also had a blood allergy test which came back clear. I'm at my wits end as the my GP says that there isn't really anything else that he can do. I just don't want to feel like this for the rest of my life.

#10 Post by **ladyjenie** » Thu Jun 25, 2009 10:46 pm

Rachesi, a sleep study is necessary to tell if you are having apneas during your sleep. It could be obstructive, central, or mixed apnea. I'm no expert but I saw over 10 physicians before one of them ordered a sleep study. My symptoms were sleeping more than usual, 14-16 hours a day. I had trouble driving my car because of fatigue. I began having restless legs and severe sweats. My GP referred me to an ENT and he told me the surgery was too involved for a person my age (then 54). I sleep with CPAP at night and have improved. Now, 3 years later and my 2nd set of braces I'm having uvula/soft palate/turbinates reduction along with TJR and will soon be rid of the CPAP. I don't bank my faith in that most physicians will order a sleep study from your symptoms, mine didn't. I saw GP's, internal med docs, 3 rheumatologists, 2 neurologists and finally one of the neurologists suggested I do the sleep study. God Bless her! Politely ask your doctor for a sleep study so you can be treated appropriately. Good Luck!

#11 Post by **rachesi** » Sun Jun 28, 2009 2:34 am

ladyjenie wrote:Rachesi, a sleep study is necessary to tell if you are having apneas during your sleep. It could be obstructive, central, or mixed apnea. I'm no expert but I saw over 10 physicians before one of them ordered a sleep study. My symptoms were sleeping more than usual, 14-16 hours a day. I had trouble driving my car because of fatigue. I began having restless legs and severe sweats. My GP referred me to an ENT and he told me the surgery was too involved for a person my age (then 54). I sleep with CPAP at night and have improved. Now, 3 years later and my 2nd set of braces I'm having uvula/soft palate/turbinates reduction along with TJR and will soon be rid of the CPAP. I don't bank my faith in that most physicians will order a sleep study from your symptoms, mine didn't. I saw GP's, internal med docs, 3 rheumatologists, 2 neurologists and finally one of the neurologists suggested I do the sleep study. God Bless her! Politely ask your doctor for a sleep study so you can be treated appropriately. Good Luck!

Hi Ladyjenie, thanks for your response. I also have trouble driving my car, which is worrying, as I believe it increases my reaction time. I went to my GP the other day, and he said that he couldn't refer me, only a specialist could, so I have yet again been referred to ENT; however the waiting time is 4-6 weeks, so I might be waiting a little while. Having said that, I feel like they'll just say no anyway, as I'm in my early twenties, I'm thin, and I'm female, so I'm not the stereotypical sufferer of sleep apnea. However I do have the recessed jaw, which is sometimes given as the cause, and that's why I thought I'd ask for one.

However, I don't hold much hope!

#12 Post by **changes09** » Sun Jun 28, 2009 7:28 am

Two co-workers of mine have had jaw surgery due to sleep epnea. i do not know the secific though