What are your airway measurements? (Doc wants me to get MMA)

I all, newb here. I know I've got the other thread going but it's just more of a general help type thing. I was wondering specifically if anyone has also been suggested MMA surgery and what their measurements were? My oral surgeon recommended it when doing the measurements for my TAP.

Specifically the doc was able to show me my airways on the 360 CT scan. My main big airway at the back of the throat is fine on width, 25nm, but from back to front, it was only 8.5nm. He said was because of my lower jaw being back too far. He also said normal front to back is 20-25nm. I couldn't find by googling what normal air way measurements should be. I found some results, but I don't know what each measurement name is referring to. What were your measurements?

Another thing I was confused about though is when looking up MMA online. It said the tongue is usually moved by cutting the peice is attached to and moving it forward as well as moving both jaws forward, and the procedure leaves you wired shut for at least a month. But when I asked the doctor about that he said no you won't be wired shut at all, and you may not even require upper movement that depends on the person. So is the internet telling me wrong? Have the procedure changed?

I know I haven't even gotten my CPAP yet, but I am just trying to get as much information as possible so depending on it's outcome and can move fast, since hpositals and doctors move so slow, and I am suffering horribly right now. I am considering getting this done, especially if they don't need to do anything to my upper jaw, because then recovery and the procedure is way way easier.

I also wonder why they don't do sleep edoscopys before ordering this kind of surgery. I've read all kinds of surgeries that can be performed for sleep apnea depending on the part, but they aren't even sure what part is causing the problem. Okay I may have a narrow airway, but is my soft palette still going to collapse even if my lower jaw gets extended forward? That was another weird thing about it, He showed my measurement of my soft pallete was lik 34nm, and the space from the top of the soft pallete to the back of the airway was 20nm. It seems like if the soft pallete is collapsing, there's tons of extra space there for it to fold back on and moving my lower jaw forward wouldn't correct it. But we don't even know if that is what is causing the obstruction.

I suggest you go to Dr. Steven Park's website - someone posted the link on your other thread. He explains ALL OF THIS in his articles and posts. You can also get regular updates from him. He is an ENT surgeon.

Hi sventory,

This forum is no longer active but there alot of great posts on the MMA that you might find helpful.

http://www.needsleep.net/apnea/apneainf.html

You also might take a look at this site which is run by Kasey Li, whom I think is the best surgeon in the world, regarding doing this procedure.

http://www.sleepapneasurgery.com/maxill ... ement.html

I can't find what he said about sleep endoscopy and MMA but essentially, he explained the reason it wasn't necessary because having the surgery would take care of all the obstructions that other surgeries tend to miss which leads to a lower success rate.

Ok, having given you these links, while I am definitely not anti surgery, I would try pap therapy first to see if you can get it working. The good surgeons like Dr. Li will advise you to do the same thing.

I understand the desperation. If you want to PM me to talk more, please feel free to do so.

sventory wrote:I all, newb here. I know I've got the other thread going but it's just more of a general help type thing. I was wondering specifically if anyone has also been suggested MMA surgery and what their measurements were? My oral surgeon recommended it when doing the measurements for my TAP.

Specifically the doc was able to show me my airways on the 360 CT scan. My main big airway at the back of the throat is fine on width, 25nm, but from back to front, it was only 8.5nm. He said was because of my lower jaw being back too far. He also said normal front to back is 20-25nm. I couldn't find by googling what normal air way measurements should be. I found some results, but I don't know what each measurement name is referring to. What were your measurements?

Another thing I was confused about though is when looking up MMA online. It said the tongue is usually moved by cutting the peice is attached to and moving it forward as well as moving both jaws forward, and the procedure leaves you wired shut for at least a month. But when I asked the doctor about that he said no you won't be wired shut at all, and you may not even require upper movement that depends on the person. So is the internet telling me wrong? Have the procedure changed?

I know I haven't even gotten my CPAP yet, but I am just trying to get as much information as possible so depending on it's outcome and can move fast, since hpositals and doctors move so slow, and I am suffering horribly right now. I am considering getting this done, especially if they don't need to do anything to my upper jaw, because then recovery and the procedure is way way easier.

I also wonder why they don't do sleep edoscopys before ordering this kind of surgery. I've read all kinds of surgeries that can be performed for sleep apnea depending on the part, but they aren't even sure what part is causing the problem. Okay I may have a narrow airway, but is my soft palette still going to collapse even if my lower jaw gets extended forward? That was another weird thing about it, He showed my measurement of my soft pallete was lik 34nm, and the space from the top of the soft pallete to the back of the airway was 20nm. It seems like if the soft pallete is collapsing, there's tons of extra space there for it to fold back on and moving my lower jaw forward wouldn't correct it. But we don't even know if that is what is causing the obstruction.

GET A SECOND OPINION.....This is major surgery with no guarantee of success.

My Dr. Told me I have a super tiny airway, But never suggested surgery even though he thought I would not tolerate cpap. He suggested drugs. Forget it! I will have been on cpap for two years this coming Thanksgiving. Am I ever thankful for cpap. It took a while and after ignoring my Doc and raising my pressure gradually(only to a high of 11) my morning Sleepyhead results are nearly always well under one. It took time but with the help of many here I love my ugly machine. Try cpap with sleepyhead + this group first, you cant go back after surgery.

Thanks for the uplifting success story Islandwoman. I pray to any and all gods this suffering can be over soon. Everyday I have in the back of my mind how long can I survive on so little sleep before I lose my mind, do I have sporadic fatal insomnia and am I actually going to die in the next year or 2? What if the PAP cures my apneas but I still can't sleep? What if my nervous system is just in a constant state of hyper exicatability now? Ugh. Your story and all the support on here has been great for me. I just want my damn machine already to finally stop worrying and just try it!

sventory wrote:Doc wants me to get MMA

Sorry, I haven't followed your posts very closely, but it seems you haven't had a definite diagnosis of your problems. MMA is major surgery. No one should get an MMA without a clear diagnosis.

ChicagoGranny wrote:

sventory wrote:Doc wants me to get MMA

Sorry, I haven't followed your posts very closely, but it seems you haven't had a definite diagnosis of your problems. MMA is major surgery. No one should get an MMA without a clear diagnosis.

Yes I have received a diagnosis, I have OSA. It's just I had sleeping problems before the diagnosis, but I never got a sleep study 7 years after having trouble sleeping. Jaw doctor says its obvious why I have trouble breathing because my airway back to front is way too narrow, less than half a normal persons. I just haven't gotten any treatment yet because doctors are slow as hell. 2.5 months since diagnosis and I just got my TAP tonight and probably another 2 weeks before auto pap comes.

sventory wrote:Yes I have received a diagnosis, I have OSA.

Can you post the details of your diagnosis? AHI? RDI? Oxygen desats?

It seems unusual for a doctor to recommend MMA surgery without first a long, determined effort at CPAP. I would be surprised if insurance would approve MMA until the patient fails CPAP, but I really don't know.

Be sure you read this first: viewtopic/t108593/my-CPAP-and-surgery-story-MMA.html

It's a lot of pain and expense to go through to end up ... On CPAP. Note that you must be VERY clear how your surgeon defines "success" for the surgery. It's not necessarily what you think.