Maxillo-Mandibular Advancement Surgery for Sleep Apnea

[Slinky]

I borrowed this post from the apneasupport forum because I thought it might be of interest to a few of our members:

Maxillo-Mandibular Advancement Surgery for Sleep Apnea
Just letting everyone know that I'm hosting a live telephone interview with Dr. Kasey Li, a world renown otolaryngolgoist and oral-maxillofacial surgeon that specializes in sleep apnea surgery. He and his colleagues at Stanford have published numerous papers related to surgical and nonsurgical management of sleep apnea. We're going to talk about maxillo-mandibular advancement. It's not a commonly performed procedure, but when done in the appropriate patient by an experienced surgeon, the success rates have been reported to be well above 90%. We're going to discuss how he chooses which patients are good candidates and what's involved during the procedure and what to expect afterwards.

You can ask Dr. Li your questions during the registration or live during the call. If you can't make it, you'll get a link to the recording, but only if you register.

It will take place on Jan. 8 at 8PM Eastern, and last about one hour. Register here to get the telephone call in details: http://tinyurl.com/7lgnuv

Hope you can join me.

Steven Y. Park, M.D.
http://www.doctorstevenpark.com

I realized that some of you may not even know what a mandibulo-maxillary advancement is. It's not palate or tongue surgery. This is where oral-maxillofacial surgeons pull your upper and lower jaws forward about 1/2 an inch. At Stanford, they offer this procedure to people who fail Phase I soft tissue multilevel surgery. There are some reports of doing this as a primary procedure. For many of you, this is not even an option, but for the sake of listening in on one of the premier sleep apnea surgeons talk about his rationale for doing this type of surgery, and what to expect, I think it will be a very educational experience for everyone, even if you are doing well on CPAP. You can register at the top of the post to get the telephone call-in information, as well as the link to the recording afterwards.

Steven Y. Park, M.D.
http://www.doctorstevenpark.com

[packitin]

Thanks, Slinky, for that information.
I looked at several articles at his web site.
I was interested in surgery at one time. But the ENT told me I was not a candidate.
I don't know why. He also said that any of his procedures were not covered my Medicaid.
So I gave up and did not pursue this avenue anymore.
But a couple of questions come to mind.
What is his criteria for a "good candidate"?
How many times would one have to travel to his office (in New York, I presume)?
About how much is the total expense?
(Also, I didn't know Michael Phelp's long angular face makes him more apt to get OSA- Yikes!)

[Slinky]

I can't answer any our your questions, packitin. Surgery is not something that's been indicated, suggested or considered for or by me. I just know that there are others who have considered it or need it that I thought would find this of interest. You can register and take part in the telecast and ask your questions at registration or live if you like.

[Bearded_One]

I had an MMA about 13 years ago and it was over $10,000 (it wasn't called an MMA back then). MMA's are major surgery and have a difficult recovery time. One possible problem with MMAs is facial nerve damage, my lips and part of my mouth are permanantly partially numb.

I also later had a UPPP -- and I still have severe apnea. My insurance at the time paid 100% for both surgeries, and I wish that it had denied the MMA. I also wish that I hadn't had the UPPP, but I am very glad to have my tonsils out because I had chronic strep throat before the UPPP.

[Billy6]

Respironics (the maker of most of our machines) has made available to dentists a mandibular advancement device (like a football mouthpiece) that takes a dentist 20 minutes to form & fit and you're ready to go. Many say these types of devices are scams--I doubt Respironics is a scam company. It sure beats surgery, and may be a good travel device instead of lugging your machine through secondary inspection at airports

[Slinky]

Thanks, Billy6. I'm sure there are those in the forum that will be real glad to learn of this!

[rested gal]

When it comes to something as drastic as MMA surgery, I think the experience, expertise, and skill of the surgeon would be of the utmost importance not only in choosing candidates, but also as to whether there would be a good outcome or not. Not all surgeons are created equal.

A poster nicknamed billinseattle went to Dr. Kasey Li for that surgery and did well.

Bill's posts describing the surgery, his recovery, etc. are in the MMA links (bottom third of the page):
LINKS to surgery, turbinates, Pillar, TAP experiences
viewtopic.php?t=2836

[nate fry]

I think the way they see if you can do it is a facial exray where they measure your facial structure.I had the exray and they have measurements of all your facial bones , chin lenght and etc. I had the tounge advancement and it worked great. No more choking for me. I can even sleep on my back again.

[Slinky]

Thanks, Nate. Its good to hear some success stories! Do you still use CPAP tho since the surgery? Were you able to lower your pressure by much if so? How difficult was the tongue advancement surgery to go thru and recouperate from? Who did your surgery? Was it done at Stanford or where?

[Guest]

HI
I had this surgery about 20 years ago to correct my chin. The surgery and recovery were rough, but I'm told the procedure has been improved greatly. I was diagnosed with sleep apnea a few years ago- apparently the surgery is not necessarily a "cure"!

[packitin]

deleted

[jskinner]

What is his criteria for a "good candidate"?

They take an xray and then do specific calculations on it. You can see mine at http://james.istop.com/apnea/reports/Ja ... atxRay.jpg

I was interested in surgery at one time. But the ENT told me I was not a candidate.

You really need to see an oral and maxillofacial surgon about MMA.

How many times would one have to travel to his office (in New York, I presume)?

Dr. Li is in California.

About how much is the total expense?

Dr. Li told me "The cost of MMA at Stanford is about $75,000"

I'm currently scheduled for an MMA in Canada on Oct 22, 2009. I'm hoping to find a way to avoid it before then.

One of the best MMA sites is http://www.rogerarrick.com/mma/

[packitin]

Wow, what a post! I've been sitting here for a long time trying to take it all in.
I will probably have to review this several times to soak it all in.
Thanks for this, I appreciate it.
Jay

[OutaSync]

James,

Don't you still have that other surgery scheduled for tomorrow? Good luck with that, and as soon as you are able, please let us know how it went. We'll be pulling for you.

Bev

[jskinner]

Don't you still have that other surgery scheduled for tomorrow?

The nasal surgery date got moved slightly, its now Jan 13th at 11am. I travel from Canada to Ohio for it on Jan 10th, next Sunday.