Matthew Stoughton presented to me on August 16, 2012 to discuss surgical options for correcting his obstructive sleep apnea. Matt is well-informed since he has been dealing with his condition since 2002 and has been treated with a variety of CPAP masks, pharmacology, and surgery. Surgically, he has completed all phase I options including FESS, septoplasty, turbinectomy, and UPPP, yet he still requires 9 cm of water pressure to achieve any sort of efficacy. Matt attempts to use his CPAP but cannot tolerate more than three hours with it. In spite of all previous interventions, Matt's September 1, 2011 sleep study identified an RDI of 46 with oxygen desaturations to 75%. The only option Matt has not pursued is a mandibular positioning device, but the severity of his OSA as well as TMD/rheumatoid arthritis eliminates this treatment option.
During my evaluation, it became apparent that Matt has well-camouflaged, but significant, maxillary and mandibular hypoplasia that is the etiology for his disease process. Surgical correction for this problem includes a 10mm maxillary advancement (segmented and bone grafted to manage a maxillary transverse deficiency) followed by a mandibular advancement which will move his chin point anteriorly 18mm.
In plain English, my jaw's too small and a little off-center.
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