Fenghua United Clinic wishes everyone a Merry Christmas 2024!

Discuss the case of sleep apnea treatment in a female patient with long chin. Unlike other patients with mandibular retrusion, her airway obstruction point was located in the retropalatal space and nasal cavity. It was diagnosed that it was caused by maxillary retrusion and stenosis. Through clockwise rotation of both jaws, orthognathic surgery moves the upper jaw forward and simultaneously reduces the thickness of the inferior turbinate, successfully improving respiratory problems. This case shows that sleep apnea has multiple causes and requires accurate diagnosis and customized treatment plans.

A patient with moderate to severe sleep apnea had a minimum blood oxygen concentration of only 44% during sleep. Not only did he suffer from severe snoring, but he also experienced dangerous breathing difficulties at night. Through the 3D customized orthognathic surgery performed by Dr. Jiang Houren of Fenghua United Clinic, the maxillary bone was moved forward by 6mm and the mandibular bone was moved forward by 12mm. This not only improved the problem of respiratory tract stenosis, but also solved the problem of facial distortion. After the operation, the patient's sleep quality has been significantly improved, snoring is no longer a problem, and the airway expansion has brought unprecedented smoothness.

Effectively treat sleep apnea through airway lift and jaw surgery! In this case, the patient's initial treatment with a positive pressure respirator was not effective and affected his quality of life. After counterclockwise rotation of the upper and lower jaw, combined with chin osteotomy, it not only improves the airway compression problem, but also balances the side lines of the face. Sleep breathing testing showed that the AHI index dropped significantly from 50.1 to 13.4, and the snoring situation was significantly improved, bringing patients better sleep quality.

This is a patient with extreme sleepiness. His Epworth Sleepiness Scale score is 17. If the score is over 10, it is considered to have reached the level of sleepiness that requires medical intervention. The sleep report he brought from the hospital showed that his AHI was as high as 64.5 (AHI>30 is severe sleep apnea) and his lowest blood oxygen level reached 60%. For patients with retruded mandible and severe sleep apnea, orthognathic surgery (Maxillo-Mandibular Advancement, MMA) should be one of the priority treatment options, especially since this patient is completely unable to accept having to wear a positive pressure ventilator for a long time. The CT scan after the operation showed that the narrow and blocked airway had been widened and supported through the reorganization of the upper and lower jaws. At the same time, the face shape, jaw line, tooth angle and bite state also benefited from the orthognathic surgery. Most importantly, the postoperative sleep report showed that the AHI had dropped to 4.3, which is the same as the normal standard, and the minimum blood oxygen level had increased to 83%. Subjectively, in addition to greatly reducing snoring, he felt much more energetic during the day and was not sleepy.

This patient had undergone orthodontic treatment with tooth extraction before, but later she found that the problems and concerns she had far exceeded whether her teeth were straight. This time she was referred to our center by a sleep specialist dentist, mainly to solve her severe daytime sleepiness and snoring problems during sleep. After a sleep test, she was diagnosed with moderate sleep apnea (AHI=19.4). CT also showed that her airway stenosis was caused by severe retraction of the mandible, which compressed the posterior airway space. Taking into account her obvious symptoms of sleep apnea (sleepiness, snoring), the cause (narrow bones, lack of space), and her expectations for appearance and occlusion, we designed an orthognathic surgery (MMA: maxillo-mandibular advancement) for her, which would widen her airway and improve her appearance and occlusion. Postoperative orthodontic treatment was performed by the referring physician using Invisilign. The sleep test result six months after the operation was AHI=1.4, which has returned to normal. The symptoms of snoring and sleepiness have disappeared, and she also likes the way she looks after the operation more.

A 29-year-old male patient was troubled by severe sleep apnea (AHI=39.6) and was unable to adapt to positive pressure respirator treatment. Through 3D customized orthognathic surgery, counterclockwise rotation technology is used to rotate the upper and lower jaw bones forward and perform bilateral turbinoplasty. The postoperative results were significant: AHI dropped to 4.7 (improved by 88.13%), minimum blood oxygenation increased from 79% to 94%, and respiratory tract volume increased by 76.6%. This case demonstrates the effectiveness of orthognathic surgery in the treatment of sleep apnea.