Jaw surgery for sleep apnea

[Jbird]

Hi all. I'm going to start asking questions. My surgeon recommended upper and lower jaw surgery plus a UPPP plus nasal surgery plus tongue tie surgery. I was like, what all at the same time. He said yes, because there is only one recovery. Then later they have said I might need TMJ surgery as well. Has anybody ever been told to do all these at once for sleep apnea? Seems like a lot. I read on here about people undergoing jaw surgery, but what about adding all these to it? I have a fear of not being able to breathe when I wake up.

I have since emailed this question and get no answer.

Thanks for reading.

[snapdresser]

I refused to get UPPP. My primary care doc scared me away from it, talking about never being able to drink soda again, having to relearn how to swallow, etc. Nasal surgery I would consider, tho! In fact, I still am, as I continue to have allergic rhinitis ever when I take Zyrtec and Nasacort. I just got a bimax with genio to treat sleep apnea. Someone else on here also got a turbinectomy at the same time, but you're the first to mention also getting UPPP as far as I can remember. Regardless, you'll be loosely banded after the surgery so you'll be able to breathe through your mouth immediately post-op. UPPP and any of those other things shouldn't affect that negatively. Still, that's some pretty drastic reconstruction; you might want to consider getting a second opinion before going along with that surgeon's recommendation.

[Jbird]

Yes, the UPPP really scares me. I had a dentist tell me don't do it. I went ahead with the nasal surgery though and let my ENT do it. Got septoplasty for deviated septum and turbinate reduction. It has made a world of difference. I didn't want to wait for the jaw surgery to do it because of blocked nose all the time. I can really breathe through my nose now. No more breathe rite strips or nasocort or flonase. All clear. So I highly recommend it.

But this doctor office is the one ignoring my questions so I've started to ask on this forum. Yes, I'm probably going to get a second opinion.

[snapdresser]

Is this surgeon proposing to do even more work on your nose?

Did you have them make any cosmetic changes to your nose or you left it as-is appearance-wise?

[Jbird]

I emailed them and told them I went ahead and did the nose, so I assume they know, but I'm not getting confirmation that he knows because there was no answer.. but the jaw surgery is so far out in the future I wanted to get it done. I hope he doesn't feel the need to do it again. I'm so glad I did it. It wasn't too bad. Just off work a week. Sometimes you just have to go with your gut when it comes to your health. Nobody cares as much as you do.

[SingleJawMelb]

Yes, the UPPP really scares me. I had a dentist tell me don't do it. I went ahead with the nasal surgery though and let my ENT do it. Got septoplasty for deviated septum and turbinate reduction. It has made a world of difference. I didn't want to wait for the jaw surgery to do it because of blocked nose all the time. I can really breathe through my nose now. No more breathe rite strips or nasocort or flonase. All clear. So I highly recommend it.

But this doctor office is the one ignoring my questions so I've started to ask on this forum. Yes, I'm probably going to get a second opinion.

I had the same thing done to my nose. Can't say it made the difference to anything, because I'm a mouth breather but after my BBSO I can breath with my mouth shut.

Doctors generally don't answer questions via email. You had the change at the consult, so book in for another consult (with a different surgeon). I think you need to take these hints that a dentist is telling you not to do it and also no reply as a sign.

[Jbird]

Snapdresser, I like your name. I had a septoplasty and nasal turbinate reduction done by ENT and it was all inside, nothing cosmetic.

[Nozzelnut]

Double jaw surgery had more benefit then UPPP for me. Mine were about a year apart; tonsils/adenoids/uppp in 2014 and double jaw in 2015. Getting rid of the chronically infected/inflamed tonsils was good. Trimming soft palate and removing my uvula didn't have the outcome I was hoping for. I was aware of the problems of removing too much soft palate (liquids coming out your nose when swallowing aka nasal regurgitation...) and I expressed my concerns to my ENT so he wouldn't take too much away. Looking back I would have gone with a uvula trim instead of removal. Mine was exceptionally long; touching my tongue, from years of snoring, sleep apnea and irritation.

I had turbinate reduction and my deviated septum fixed during my double jaw surgery. That helped my nasal breathing a lot. But turbinates grow back slowly; 6-7 years so it might not be a final solution if you have them removed.

[snapdresser]

I went to an ENT 9 months or a year after my surgery cuz I was still having chronic difficulty breathing through my nose (although it's much better than it used to be pre-op) and he said that 1) I have inflammation due to allergies and I should have that treated, and 2) when my maxilla was impacted, it pushed it up into the floor of my nose, which is really where almost all of the airflow through the nose goes. He said that if I treat the allergies and it still bothers me, he'd go in and trim down a bit of the maxilla where it was pushed up. Anyone have any luck with such a thing? I'd be kind of concerned that he's an ENT and not a maxillofacial surgeon and might not be familiar with the ins and outs of orthognathic surgery in terms of where the roots of my teeth are and exactly how much of the maxilla could be trimmed off without causing side-effects.

[Jbird]

Have you asked your surgeon about it? Maybe he could fix it. I think there's a crossover in the level of expertise of an ENT and an oral surgeon, both working on the facial area. That's why my oral surgeon wanted to do the jaw surgery, UPPP and nasal surgeries all at once. My ENT thought I was crazy to consider jaw surgery for sleep apnea, but acknowledged that he couldn't cure the sleep apnea with his procedures, since my sleep apnea is severe. I think either doctor is qualified to fix your problem. I trusted the ENT with my nose and went ahead and got it done. He did a good job and I can breathe so much better through my nose, although it did not affect the sleep apnea at all. He did try to treat me with allergy meds first, and when it didn't help he recommended the nasal surgeries. Hopefully, you can get this done and breathe through your nose again. It's so much healthier too than mouth breathing.

I hope my jaw surgery doesn't mess up my nose again.

[snapdresser]

I breathe through my nose all the time now, but one side or the other gets stopped up fairly regularly.

[Jbird]

I have learned so much about that through Steven Park.com . He's an ENT that wrote the book Sleep Interrupted. He has a free ebook called how to unstuff your stuffy nose, and his website has a lot of info might be helpful.

[JawGuy31]

I don't think every UPPP are the same. I had for sleep apnea too (read my post)
http://www.archwired.com/phpbb2/viewtop ... 15&t=51073

I'm not having to relearn how to swallow again or anything like that, everything pretty normal here.

[Jbird]

Wow, you sailed through it. I'm whining about just my braces bothering me. Everyone is different, but this give me some hope that it's not going to be that bad. In the end I will just have to trust my doctor and what he thinks needs to be done. Thanks. Sounds like the UPPP didn't cause you extra pain at all.

[JawGuy31]

[quote="Jbird"]Wow, you sailed through it. I'm whining about just my braces bothering me. Everyone is different, but this give me some hope that it's not going to be that bad. In the end I will just have to trust my doctor and what he thinks needs to be done. Thanks. Sounds like the UPPP didn't cause you extra pain at all.[/quote]

Yeah it really depends on what UPPP you are having, seems like mine was just a readjustment/advancement, some other UPPP they do some butchery. Discuss your concerns with your doctor, also keep the positive mind I can assure it will make a difference