Sleep Disordered Breathing and OSA Surgery
Sleep Disordered Breathing and OSA Surgery
Sleep apnea is a serious medical condition where the patient’s breathing repeatedly stops for a long duration while he/she is asleep.
What is Obstructive Sleep Apnea (OSA) Surgery
Sleep apnea is a serious medical condition where the patient’s breathing repeatedly stops for a long duration while he/she is asleep. Patients often wake up gasping or choking when suffering from sleep apnea. Due to this repeated choking episodes, the patient is unable to sleep for the necessary duration and hence sleep quality is deteriorated. Because of this, the person feels continuously tired throughout the day, has morning headaches, is unable to concentrate on work, falls asleep easily during the day(daytime sleepiness). This, in turn, affects the quality of life and many aspects of day to day life.
These patients are also known to be at risk of developing high blood pressure, heart problems, high risk of stroke, decreased libido etc.
There are different types of sleep apnea but Obstructive Sleep Apnea (OSA) is the most common one. This type of apnea occurs when your throat muscles intermittently relax and block your airway during sleep. This causes obstruction in the airway pipe and results in decreased concentration of oxygen in your blood. If this oxygen concentration falls below a certain limit, your brain will automatically wake up your body, which in turn will correct the obstruction in the airway. Because of the repeated waking episodes, the sleep remains constantly disturbed. Partial obstruction of the airway will result in snoring. Snoring does not always mean that patient has OSA.
OSA is seen more commonly in males than in females. Though it is more common in adults, many children also suffer from OSA which affects their growth as well.
How Can Obstructive Sleep Apnea Be Treated At Pandit Clinic?
Management of OSA requires a multidisciplinary team which includes general physician, pulmonologist, ENT surgeon, maxillofacial surgeon, dentist, psychiatrist, sleep technician etc.
If the person is suspected to have OSA, he/she is subjected to various investigations by Dr Vikram Pandit, who is a highly qualified Oral and Maxillofacial Surgeon at Pandit Clinic, Pune.
Polysomnogram(PSG), commonly called “sleep study” is the gold standard to diagnose OSA. It can be done in a hospital setting or even at your own house.
Based on these results, CT scans/radiographs will be done, also naso-endoscopy can be performed to know the exact location of the obstruction in the airway.
Drug-induced sleep endoscopy(DICE) is one of the new addition to the diagnostic methodology.
There are various ways to treat OSA. One of them includes using a doctor prescribed continuous positive airway pressure (CPAP) therapy machine. This device supplies constant pressurized air to the upper airway tract via a sleep apnea mask.
This pressure will help prevent the airway collapse during sleep. If there is obstruction in the nose, various intra nasal surgeries can be performed to correct nasal obstruction. These includes correction of nasal septal deviation, inferior turbinate reduction, opening of the internal nasal valve, widening of the anterior nasal aperture etc. many surgeries can be performed on the soft palate and muscles in the throat to help reduce the airway collapse.
The most common of these is uvulo-palato-pharyngoplasty and its variations. Also tongue base reduction surgery will help reduce the tongue size and hence open the airway.
Mandibular Advancement Device (MAD)
These are the devices made from acrylic and worn by the patient in the mouth. This device helps to keep the lower jaw(mandible) in a protruded position. This, in turn, will keep the tongue in the forward position and prevents the airway blockage because of the tongue. Various designs are available in the market. The disadvantage is patient compliance with these devices. These devices can be fabricated by a dentist trained in this field. These appliances are very effective in reducing snoring.
Dr Vikram Pandit is specially trained in the treatment of OSA by performing particular orthognathic surgeries. These include a Maxillomandibular advancement surgery and/or Genioplasty procedure.
What Is A Maxillomandibular Advancement Surgery?
Abnormality of the maxillofacial skeleton is a well-recognized risk factor of obstructive sleep apnea. Sleep apnea patients usually have small, narrow jaws that result in diminished airway dimension, which leads to easy airway collapse during sleep. Small lower jaw/ retrognathism/ double chin are some of the complaints of these patients.
Other people who are good candidates for this surgery are those who cannot use CPAP/ MAD, and previous nasal/pharyngeal surgeries have failed to show a success.
In this procedure, the upper and lower jaws are moved forward from the rest of your facial bones. This enlarges the space behind the tongue and soft palate, making obstruction less likely. Various studies in the literature have shown that MMA surgery is one of the most successful procedures in the treatment of OSA.
Patients who have moderate-severe OSA benefit the most from this procedure. This surgery will also improve the cosmetic appearance of the patients who have small jaws.
Most of the children suffering from OSA will benefit from minor ENT surgeries. If they have some maxillofacial abnormalities, it can be corrected at an early age using the orthodontic treatment and using various myofunctional appliances which can correct growth abnormalities.
Consult Dr Vikram Pandit
Oral & Maxillofacial Surgeon
Book a consultation with Dr Vikram Pandit. At the consultation, Dr Vikram Pandit will:
- Dr. Vikram Pandit will first perform a thorough examination of your teeth, gums and jaw.
- Explain the problem to you.
- An X-Ray of your teeth will be taken if needed.
We recommend you openly discuss your concerns with Dr. Vikram.
During the consultation be prepared to discuss:
Dr. Vikram PanditBDS, MDS Oral & Maxillofacial Surgeon
Meet the Doctor
BDS, MDS Oral & Maxillofacial Surgeon
Dr. Vikram is a visiting consultant and consultant oral and maxillofacial surgeon at the top hospitals in Pune like Poona Hospital and Research Centre, Ratna Memorial Hospital, Pandit Clinic and KEM Hospital. Dr. Vikram has done clinical fellowship in craniofacial surgery with focus on surgery for cleft lip and palate deformities, orthognathic surgery and surgery for sleep related disordered breathing (SRDB). He has trained for advanced management for Facial Trauma, from Taiwan. He has also attended various seminars and done workshops related to Oral and Maxillofacial Surgery. Dr. Vikram is also a co- author of a chapter for a textbook. He has been invited as a speaker for number of conferences in India as well as Internationally.