Anyone have surgery for sleep apnea and fail to cure it?

[molestrip]

Just curious, does this actually happen? I've heard advancements in my case ranging from 10mm to 15mm. I've been leaning closer to people with the 10mm suggestion. I'm told I'm currently at 6-7mm with an AHI of 50.

[dantheman]

Depends.

There is a chance of failure or partial failure if the advancement is too conservative. There is ALWAYS a risk to surgery, in this case a failure to resolve your underlying problem.

It also depends on the type of surgery you are considering.

Assuming you are considering a BSSO, you might consider a sleep study with a titratable mandibular advancement splint. It might indicate whether 10mm is sufficient to prevent apneas/hypopneas, or if you need 15mm advancement. Unfortunately, this brief snapshot is all the objective evidence available to give you surgical direction.

Surgery for OSA is not a perfect science. Improve your parameters by losing weight, sleeping on your side, avoiding alcohol and sedatives, and focusing on nasal breathing (or treating an underlying nasal issue).

[molestrip]

Can a MAD go out that much? I'd assumed not because it's not considered a treatment option for severe OSA.  The only item I need to work on there is nasal breathing but I don't see how that'd affect OSA. Mouth breathing, while not ideal, is subject to the same obstructions are nasal breathing.

[dantheman]

If your nose is clear, breathing with your mouth closed lowers the overall airway resistance. Lower resistance = less frequent obstructions. So if you have a plugged nose and sleep disordered breathing, treating this issue first is paramount.

As for MAD in severe sleep apnea, no it is not considered first line. But if someone does not tolerate CPAP, it still remains a viable option to lessen OSA.

[molestrip]

How much of a difference you think it'd make? My AHI is 50. I'm doing allergy shots now but it'll take a year to see if it works. If not, then I'll get a turbinate reduction. I need jaw surgery anyway. My bite is very messed up and it's starting to cause muscle pain and significant tooth loss. If I didn't have sleep apnea, then I could get away with single jaw surgery though.

[Langpam]

I had bimaxillary plus genioplasty in November to cure my sleep apnoea ( results of the sleep study in December showed that I have gone from 67.5 apnoeas an hour to ZERO). I had a massive mandibular advancement. My surgeon told me that all his patients were cured and no longer needed their CPAP