Effectiveness Of Only Maxillary Advancement On OSA

by Anonymous

Why does obstruction in nasal breathing cause OSA? Why doesn't the body succeed then in breathing through the mouth, assuming the tongue isn't in the way? Can diagnostic imaging (supine, awake) reveal if OSA is caused by the tongue vs. the upper tissues / soft palate? Can moving only the upper jaw forward improve OSA, or must both jaws be moved (MMA)?

I'm a 32-yro male born with oligodontia, and my upper jaw never grew forward far enough to meet my lower jaw, so my bite is severely in class III malocclusion. I have OSA, and my doctor thinks I've had it my whole life; when I wake in the morning, it's like 8 hours of darkness have passed; I have no sense of having dreamed. As a child, other kids would talk about their "dreams" but I could never relate.

I'm ineligible for a traditional Maxillomandibular Advancement because my lower jaw bone is too thin. However, my lower jaw appears to be forward enough, and I underwent a maxillary advancement surgery 16 months ago where my upper jaw appears to have been advanced 5-6mm. I noticed some improvement in sleep (I no longer wear CPAP) but I still dream rarely and not vividly at all. In the lab, I now show few obstructive apneas, but many hypopneas and RERAs, with much of my time spent in stage 2.

Can I expect a repeat maxillary advancement to improve my situation? Or is my brain permanently "damaged", having never developed under the influence of healthy sustained REM sleep?

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