The role of the maxillofacial surgeon in the treatment of Sleep Apnea

Sleep Apnea is very widespread problem among the population and it is also a condition that requires a multidisciplinary treatment. Why does the maxillofacial surgeon play such an important role in OSAS treatment? ¿What other specialists should intervene in the process?

The Obstructive Sleep Apnea Syndrome (OSAS) is a multifactorial and chronical condition, i.e., its correct treatment requires a long-term control of multiple causal factors. Such monitorization includes behavioral, medical and surgical measurements, which should be carried out by a series of specialists: family physicians, psychologists, pulmonologists, endocrinologists, odontologists and maxillofacial surgeons, among others.

To this day, the PAP (positive airway pressure) is still considered the choice treatment for any degree of OSAS, and it is normally offered as the first option. This PAP consists in the application of a positive pressure by means of an orinasal mask worn during sleep. However, many patients cannot tolerate the PAP device on account of the discomfort it produces, in addition to skin and nasal irritation problems, ocular and buccal dryness, sensation of claustrophobia or choking, or rejection by the patient’s partner. In such cases, or primarily in situations where an obstruction of the airway that is surgically treatable is detected, the only alternative therapy that can definitively eliminate the OSAS is orthognathic surgery, a subspecialty of maxillofacial surgery.

¿What makes Instituto Maxillofacial a reference center in OSAS treatment?

Instituto Maxillofacial is one of a few pioneer centers worldwide in research and clinical experience in definitive surgical treatment for OSAS. We have been studying the airways of our OSAS patients for over a decade, planning their expansion by means of virtual 3D reconstruction, and analyzing our results throughout time. Our work has been published in scientific magazines of the highest profile and shared with other specialists of the area at international level. We are continuously welcoming doctors and surgeons from abroad that wish to expand their knowledge in this area.

¿Do you think orthognathic surgery is a long-lasting solution? ¿Why?

Absolutely. As recently recognized by the American Academy of Sleep Medicine, orthognathic surgery is the only surgical procedure capable of improving the polysomnographic parameters in a measure comparable to PAP. It is thus considered a definitive curative treatment.

¿What recommendations would you give to those patients that suspect they suffer from Sleep Apnea?

All patients that present any of the following symptoms: frequent snoring, respiratory pauses during sleep, frequent night awakenings, choking or night gastroesophageal reflux, daytime drowsiness, or difficulty for concentrating; should consult a doctor and undergo a polysomnographic study. Such study will confirm the absence or presence of an OSAS, in which case we recommend making an appointment with us, or a videoconference, for patients abroad; so we can advise you on the best treatment for your case.

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