Hi Forumers,
I'm on a frustrating journey of dealing with sleep apnea and jaw surgery complications. I'm hoping to get some advice from this forum regarding:
- Doctor recommendations
- Comments on Dr. Gunson and Dr. Li
- Comments proposed surgical plan
Below is my timeline. This all started because I was sleeping very poorly and had nasal/sinus issues. When I finished graduate school in 2016, I did not have enough energy to hold down a full-time job. I still don't.
May 2017 - palate expansion
Dec 2017 - palate graft
May 2018 - MMA - less-than-expected advancement due to thin bone in mandible (that was not discovered until during the surgery)
Mar 2019 - diagnosed with palate defect and maxillary non-union
Sep 2019 - root canal to clear palate defect infection
Sep 2020 - 1 year post root canal, infection clear
Present - need surgery to repair palate defect, maxillary non-union, and improve airway (I still sleep very poorly). If I have an MMA revision, it will be very difficult because of the thin bone.
My palate expansion and MMA surgeries were performed by Dr. Stanley Liu at Stanford. He failed to diagnose the palate defect and maxillary non-union so I will no longer work with him. I'm currently deciding between Dr. Michael Gunson (Santa Barbara) and Dr. Kasey Li (Palo Alto). Would one of them be better than the other for my situation? Are there other doctors I should strongly consider? I'm from Salt Lake City and living in the Bay Area, so mostly looking for California and Utah doctors. I'm open to other areas if there's good reason for it.
Dr. Gunson told me, "there are complicated cases, and then there is you." I think he's right. Here is a description of Gunson's surgical plan (written by him). If anyone has the expertise to comment on it, I would appreciate your thoughts:
1. "Inspect the anterior left maxilla where the bone is missing, debride the area (clean it out) and graft the area as needed
2. Remove hardware in the maxilla
3. Inspect the maxilla for non union or missing bone
4. If there is non union, I will remove any scar tissue, re-apply plates and screws and bone graft as needed. If there is any missing bone areas I will graft those areas as needed
5. Inspect sagittal osteotomy sites, both sides, and remove hardware on right side
6. With the above information after the surgery, I will decide if revision jaw surgery is possible or even recommended
7. If revision orthognathic surgery is recommended, work with Dr. Yoon [orthodontist] to prepare for that surgery which can occur after the grafts are mature in 9-12 months."