In the congress of the IADR (International Association of Dental Research) celebrated in Barcelona, it has been talked about what treatment would be the best for the snorer patients that suffer Obstructive Sleep Apnea.
What is the apnea?
The obstructive sleep apnea syndrome (OSAS) is produced in patients with maxillar and jaw retropositioned. When the tongue muscularity and floor of the mouth, in a layed position, in these patients the walls of the nasopharynx and oropharynx collapse, stoping the aire go through. The pressure of the airway increases and the air goes through pressurised, making the airway walls vibrate and provoking snores. If the wall colapse, we are talking about apnea, meanwhile if their diameter decrease in a 50%, about hypopnea. The diagnose is done by a study while the patient sleeps called polysomnography-Depending of the number of apneas and hypopneas in one hour of sleep, the OSAS is diagnosed.
These patients suffer an important decrease in their life quality because of: cronical tiredness, sleepness during the day, alteration in the life with their partner, intolerance by the bed partner, predisposition to accidents…
In the long term it provokes arterial hipertension, ictus, Myocardial infarction… In the 75% it affects men and 25% in women. It isn’t clear that the lost of weight improves the forecast, as the cause comes from a maxillar and jaw that have been retropositioned.
The treatment starts by using an aire mask during the sleep which blowns aire at a positive preassure. It’s the CPAP. It’s very effective, but the problem is the intolerence it creates because of its discomfort, dryness mouth, unpleasant machine and intolerence by part of the partner. In some cases it has been tried to mantain the jaw in a forward position using a dental device. But it isn’t very effective (only the 50% improve) and it provokes muscular pain in the morning and even if it’s used for months it may provoke problems in the jaw articulation. Another treatment that was tried is the resection of the palate oruvulopalatopharyngoplasty. It’s efficient in less of the 50% of the cases, and creates an unwanted effect and scar in the palate.
The most effective treatment
The best treatment nowadays is the urgery maxillo-mandibular advancement with genioplasty. It consists in advancing the maxilar and jaw at leat 10 cm, dilating the diameter of the airway. It has cured the OSAS in more than the 97% of the cases, achieving that the patient stop snoring, a correct breath, normalises its sleep and with all that the alterations that it provoked. It’s not more than a simple orthognatic surgery with a destiny of solving a respiratory and important problem. If there existed a concomitant malocclusion, a orthognatic treatment can also be done to solve it. This treatment at the same time improves the profile of the patient which is, in general biretrusive, with a remarkable dewlap, chin lack projection and tissue laxity.
Birbe Clinic is pioneer in this treatment, with fantastic results. If you suffer apnea syndrome and you want to resolve it, contact us for a first visit with Dr. Birbe, American Board of Oral and Maxillofacial Surgery Diplomat, calling to (+34) 93 212 47 37, texting by Whatsapp to (+34) 626 85 23 63 or writing a short form.
