Author Topic: Surgical Plan for sleep apnea w/ Alfaro  (Read 6144 times)

rafaaa

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Surgical Plan for sleep apnea w/ Alfaro
« on: June 24, 2021, 08:23:24 AM »
Putting this as reference or help for others,

Here is the plan for my surgery that will be in two weeks (surgery first, using TADs and invisalign post-op), with Dr Alfaro.


https://imgur.com/a/NGacmJ2

Really happy with this, hoping for a cure of my sleep apnea / UARS.

kavan

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Re: Surgical Plan for sleep apnea w/ Alfaro
« Reply #1 on: June 24, 2021, 01:17:05 PM »
Putting this as reference or help for others,

Here is the plan for my surgery that will be in two weeks (surgery first, using TADs and invisalign post-op), with Dr Alfaro.


https://imgur.com/a/NGacmJ2

Really happy with this, hoping for a cure of my sleep apnea / UARS.

It looks like a good plan. Would you happen to have a CEPH. There is something I would like to compare with the bone model.
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jawgraphy

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Re: Surgical Plan for sleep apnea w/ Alfaro
« Reply #2 on: June 26, 2021, 10:41:07 AM »
Good luck, my friend! Please keep us updated!

kavan

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Re: Surgical Plan for sleep apnea w/ Alfaro
« Reply #3 on: June 26, 2021, 09:54:20 PM »
Putting this as reference or help for others,

Here is the plan for my surgery that will be in two weeks (surgery first, using TADs and invisalign post-op), with Dr Alfaro.


https://imgur.com/a/NGacmJ2

Really happy with this, hoping for a cure of my sleep apnea / UARS.

You have a very distinct ANS but your Alfaro bone scan does not show the distintion. It almost looks like he cut off the point of your ANS in the BEFORE photo.

It looks like he is cutting a V shaped notch beneath your ANS so he can bring the rest of your maxilla forward WITHOUT giving you a deformity. It is a GOOD thing. But did he mention this to you?

Illustration included with this post.
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rafaaa

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Re: Surgical Plan for sleep apnea w/ Alfaro
« Reply #4 on: June 29, 2021, 10:39:35 AM »
You have a very distinct ANS but your Alfaro bone scan does not show the distintion. It almost looks like he cut off the point of your ANS in the BEFORE photo.

It looks like he is cutting a V shaped notch beneath your ANS so he can bring the rest of your maxilla forward WITHOUT giving you a deformity. It is a GOOD thing. But did he mention this to you?

Illustration included with this post.


Thanks a lot for the work here Kavan !
He did NOT mention this to me. I finished MSE expansion a month ago, so maybe that notch is the result of the MPS being split and healing ? And the lack of ANS in the before, a CBCT imaging mistake ? I noted your observation and if I can, I will ask him, for the sake of information, if he did plan this.

 

rafaaa

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Re: Surgical Plan for sleep apnea w/ Alfaro
« Reply #5 on: June 29, 2021, 10:39:54 AM »
Good luck, my friend! Please keep us updated!

Thank you !

kavan

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Re: Surgical Plan for sleep apnea w/ Alfaro
« Reply #6 on: June 29, 2021, 12:40:06 PM »

Thanks a lot for the work here Kavan !
He did NOT mention this to me. I finished MSE expansion a month ago, so maybe that notch is the result of the MPS being split and healing ? And the lack of ANS in the before, a CBCT imaging mistake ? I noted your observation and if I can, I will ask him, for the sake of information, if he did plan this.

It looks like a notched  CUT to the area as to leave the ANS behind which isn't really a bad thing given the extent of the forward maxilla advancement. As CBCT imaging mistake, it would depend if the Alfaro bone model plan was based on the scan to the right. Thing is, his read out has the ANS going as much forward as the max advance. Yes, you should ask him and feel free to show him the diagram I made regarding this question.
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rafaaa

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Re: Surgical Plan for sleep apnea w/ Alfaro
« Reply #7 on: June 29, 2021, 12:57:32 PM »
It looks like a notched  CUT to the area as to leave the ANS behind which isn't really a bad thing given the extent of the forward maxilla advancement. As CBCT imaging mistake, it would depend if the Alfaro bone model plan was based on the scan to the right. Thing is, his read out has the ANS going as much forward as the max advance. Yes, you should ask him and feel free to show him the diagram I made regarding this question.


It's totally possible ! Your point makes a lot of sense and I can see it too. I will ask, I screenshotted the diagram as an help ;). Surgery next week so I might only be able to ask later.

rafaaa

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Re: Surgical Plan for sleep apnea w/ Alfaro
« Reply #8 on: July 10, 2021, 01:17:17 PM »
It looks like a notched  CUT to the area as to leave the ANS behind which isn't really a bad thing given the extent of the forward maxilla advancement. As CBCT imaging mistake, it would depend if the Alfaro bone model plan was based on the scan to the right. Thing is, his read out has the ANS going as much forward as the max advance. Yes, you should ask him and feel free to show him the diagram I made regarding this question.

Hello Kavan.
Apparently Alfaro uses a subspinal lefort 1. He doesnt advance the ANS.

https://imgur.com/a/JN06zcO

kavan

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Re: Surgical Plan for sleep apnea w/ Alfaro
« Reply #9 on: July 10, 2021, 02:33:03 PM »
Hello Kavan.
Apparently Alfaro uses a subspinal lefort 1. He doesnt advance the ANS.

https://imgur.com/a/JN06zcO

Well, that certainly confirms my observations regarding what I saw in your plan as to that notch below the ANS. I certainly think that's a GOOD thing when someone either has a prominent ANS or when the maxillary advancement is significant. But on the displacement read-out you showed,  it didn't reveal the non advancement of the ANS.
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rafaaa

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Re: Surgical Plan for sleep apnea w/ Alfaro
« Reply #10 on: July 12, 2021, 08:56:05 AM »
Well, that certainly confirms my observations regarding what I saw in your plan as to that notch below the ANS. I certainly think that's a GOOD thing when someone either has a prominent ANS or when the maxillary advancement is significant. But on the displacement read-out you showed,  it didn't reveal the non advancement of the ANS.

Yes exactly. Also just as a matter of fact, he always do alar cinch and vy closure, he told me.

kavan

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Re: Surgical Plan for sleep apnea w/ Alfaro
« Reply #11 on: July 12, 2021, 10:40:20 AM »
Yes exactly. Also just as a matter of fact, he always do alar cinch and vy closure, he told me.

Those two things should also help cut down on unwanted changes to the base of the nose that could occur in the absence of those procedures.
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