Outpatient Notice | Feng Hua Joint Clinic Closed on Constitutional Day

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.

Orthognathic surgery was originally designed to improve the bite and appearance of the patient. However, in the field of treating obstructive sleep apnea, orthognathic surgery (maxillo-mandibular advancement/MMA) has become a means to tighten the collapsed (relaxed) muscles rather than an end. Improvement in appearance and bite has become an added value of maxillo-mandibular advancement.

A patient with moderate to severe sleep apnea suffers from severe drowsiness during the day and difficulty staying awake at work due to narrowing of the airway due to retraction of the mandible. After orthognathic surgery to move the mandibular forward, not only did the AHI index drop from moderate to severe to 3.7, the respiratory tract was also significantly improved, the quality of sleep was improved, and the overall mental state was completely renewed. The surgery also improved the appearance of the retracted chin and allowed the patient to regain a healthy quality of life. It was a successful sleep apnea treatment case.

A young man was troubled by severe obstructive sleep apnea (OSA), with an AHI index as high as 55.8, and symptoms such as loud snoring, daytime sleepiness, headaches, and difficulty concentrating. Because he was unwilling to use a positive-pressure respirator, he underwent mandibular advancement surgery (MMA) combined with chin advancement surgery to successfully expand the airway space. The AHI dropped to 3.9 6 months after the operation, and his symptoms were significantly improved. This case demonstrates the therapeutic effect of MMA surgery on patients with severe OSA, providing patients with a treatment option that does not require respirators.

This 50-year-old woman suffered from severe sleep apnea (AHI = 40.5), with symptoms including severe daytime sleepiness (ESS = 17) and annoying snoring. Interestingly, a CT scan revealed that, in addition to the expected narrowing of her airways, she had undergone a Wassmund and Kole procedure in her youth. This procedure involves extracting one premolar from each side of her upper and lower jaws, then repositioning the upper and lower jaws through bone cutting to correct a protruding mouth.

Discuss the treatment case of a patient with severe sleep apnea. The patient's AHI index is as high as 84.5, and he has a typical face with a receding mandible. After airway lifting treatment through orthognathic surgery, the AHI index was significantly reduced to 5.6, and the minimum blood oxygen concentration was increased from 50% to 90%. The surgery not only effectively improves the airway space, but also makes the patient's jaw proportions more harmonious. The case details the surgical plan, postoperative changes and recovery progress, providing treatment reference for patients with similar problems.