Jaw surgery for osa?

[meo66]

Hi im considering jaw surgery for my osa. I have had uppp tongue base reduction  and rhinoplasty with fixed deviated septum and chin implant.cpap intolerant. im new on here and any advice on type of  jaw surgery etc. Attached ceph pan-thank you https://imgur.com/osKsxUH https://imgur.com/bFecpsq

[GJ]

Is it accurate that you're missing some teeth and that your wisdom teeth were never pulled? You'd likely want to have them pulled before surgery.

I see a small airway (hard to say, but it looks it on the scan) and a steep mandibular angle, which both would be corrected by doing a counter-clockwise rotation. From what you provided, it looks like you're a good candidate for the surgery.

[meo66]

thank you for your help.next week iwill have 3d ct scan in bangkok .i will let you know how i get on.

[meo66]

I had a 3d ct scan today and consultation with max surgeon in bangkok- he mentioned narrowing of the airway at the base of the soft palate-he recommended bi max but never mentioned removing the chin implant and doing a genioplasty? The cost was to expensive for me{about the same price of spain- he also said he could take the wisdom teeth out on day of surgery. Is it better to get wisdoms out months before surgery.? so i am looking at india at dr sunil or dr vikram shetty or korea.

[meo66]

https://imgur.com/6OdRj7k

[GJ]

he also said he could take the wisdom teeth out on day of surgery. Is it better to get wisdoms out months before surgery.?

That's just another surgery on top of an already major surgery, so I wouldn't do them together. You could, like he said, but it's more trauma all at once...
Wisdom tooth removal isn't a walk in the park.

[Rodin]

https://pubmed.ncbi.nlm.nih.gov/29055570/

Study on implications of wisdom tooth removal before or at same time as bsso

[kavan]

https://pubmed.ncbi.nlm.nih.gov/29055570/

Study on implications of wisdom tooth removal before or at same time as bsso

It just gives an ABSTRACT of the study. If you read the entire study what does it say about the increase of risk of BAD BREAK when the wisdom tooth needed to be removed is also an impacted/ misoriented one or one not coming through the gum straight up?

[Rodin]

My apologies. This study should be accessible in its entirety.

https://www.researchgate.net/publication/263746252_Impacted_third_molars_in_sagittal_split_osteotomies_in_mandibular_prognathism_and_micrognathia

Combining M3 removal and BSSO minimizes all other costs and morbidity (as the first study states in it's abstract) but the incidence of an improper split is likely dependent on specific orientation, positioning, and root morphology. The above study would support that a mesioangulated molar relatively close to the surface, such as in the OP's scans, would not negatively impact the split as much as say one more vertically oriented and positioned lower in the mandibular body. The danger of a bad split is still there of course. Have to weigh whether the morbidity and cost of two separate procedures outweigh the increased risk of a bad split for the specific case.

[kavan]

thanz

[meo66]

so is there a chance that moving the jaws forward alone would improve my osa? i have got used to having my chin implant.i  i really need a maxo that understands osa i

[kavan]

so is there a chance that moving the jaws forward alone would improve my osa? i have got used to having my chin implant.i  i really need a maxo that understands osa i

Yes. There is a chance. Because  bimax advancement is the surgery done to improve osa.

[Sergio-OMS]

Hi im considering jaw surgery for my osa. I have had uppp tongue base reduction  and rhinoplasty with fixed deviated septum and chin implant.cpap intolerant. im new on here and any advice on type of  jaw surgery etc. Attached ceph pan-thank you https://imgur.com/osKsxUH https://imgur.com/bFecpsq

UPPP and tongue base reduction is butchery in patients with structural problems. Enlarge the box, don’t cut its content away.

I know this doesn’t help you, I’m only replying so other people can prevent damage.

[meo66]

Hi i just thought i would post my photos to maybe get some opinions? Thank you

[meo66]

Photo 2 with chin implant.