Jaw surgery technique cures over 50 per cent of sleep apnea cases

11 January 2023

Dentists will already know that any activity within the oral cavity can be linked to breathing. Positioning dentists as a key mechanism for identifying conditions such as obtrusive sleep apnea (OSA).

For patients who suffer from moderate-to-severe OSA, surgical intervention might be required. Typically this would include the removal of the tonsils or advancing the jaw to expand the upper airway.

Although being an effective treatment for OSA, patients might be concerned that jaw surgery will alter the shape of their face.

A research team in the Oral and Maxillofacial Surgery (OMFS) of the Faculty of Dentistry at the University of Hong Kong (HKU) have conducted a study to measure if their new jaw surgery technique will improve moderate-to-severe OSA.

The study published in the International Journal of Oral and Maxillofacial Surgery demonstrated that the procedure could alleviate OSA while maintaining, or even improving, the patient’s appearance.

The data showed:

  • Fifty per cent or more reduction in breathing disturbances at night after the surgery
  • Fifty-eight per cent of the patients were considered cured, showing no signs of sleep apnea

According to EurekaAlert! HKU’s surgery method involves, “a multi-segment osteotomy (cutting and reshaping bones) of the lower jaw called segmental mandibular advancement (SMA). It is a combination of a procedure to upright the anterior jaw segment to create space and a procedure to advance the whole lower jaw.

“The surgery is done to bring about significant enlargement of the skeletal airway at the base of the tongue, as well as an appealing aesthetic of the face and functional outcome in the bite.”

Dr Mike YY Leung, clinical associate professor in Oral and Maxillofacial Surgery and lead researcher, explained that multi-segment surgery had been used to improve facial aesthetics in Hong Kong for many years. But this study takes it further. He said, “It was the first-ever study to prove that SMA could also effectively bring improvement in OSA. The uniqueness of facial features among the Eastern Asian population was the reason to use this method, which takes into consideration the aesthetics and jaw function on top of the significant airway expansion.”

Dr Joan CC Wan, co-investigator of the project, said, “We believe the pilot study has set a cornerstone for a larger scale study that can observe the long-term effects of this technique and help us compare that with the other treatment methods for OSA.”

Read the study here https://www.ijoms.com/article/S0901-5027(22)00459-3/fulltext