Sleep apnea, also spelled sleep apnoea, is a sleep disorder where a person has pauses in breathing or periods of shallow breathing during sleep. Each pause can last for a few seconds to a few minutes and they happen many times a night. In the most common form, this follows loud snoring. There may be a choking or snorting sound as breathing resumes. Because the disorder disrupts normal sleep, those affected may experience sleepiness or feel tired during the day. In children it may cause hyperactivity or problems in school.
Snoring is the vibration of respiratory structures and the resulting sound due to obstructed air movement during breathing while sleeping. In some cases, the sound may be soft, but in most cases, it can be loud and unpleasant. Snoring during sleep may be a sign, or first alarm, of obstructive sleep apnea (OSA). Research suggests that snoring is one of the factors of sleep deprivation.
The hyoid bone is a horseshoe-shaped bone situated in the anterior midline of the neck between the chin and the thyroid cartilage. At rest, it lies at the level of the base of the mandible in the front and the third cervical vertebra (C3) behind.
Facial feminization surgery (FFS) is a set of cosmetic surgical procedures that alter typically male facial features to bring them closer in shape and size to typical female facial features. FFS can include various bony and soft tissue procedures such as brow lift, rhinoplasty, cheek implantation, and lip augmentation.
Upper airway resistance syndrome is a sleep disorder characterized by the narrowing of the airway that can cause disruptions to sleep. The primary symptoms include excessive fatigue and chronic insomnia. UARS can be diagnosed by polysomnography, and can be treated with lifestyle changes, dental devices, or CPAP therapy. UARS is similar to certain types of sleep apneas.
Dental surgery is any of a number of medical procedures that involve artificially modifying dentition; in other words, surgery of the teeth, gums and jaw bones.
Chin augmentation using surgical implants can alter the underlying structure of the face, providing better balance to the facial features. The specific medical terms mentoplasty and genioplasty are used to refer to the reduction and addition of material to a patient's chin. This can take the form of chin height reduction or chin rounding by osteotomy, or chin augmentation using implants.
As the name implies, orthodontic headgear is a type of orthodontic appliance typically attached to the patient's head with a strap or number of straps around the patient’s head or neck. From this, a force is transferred to the mouth / jaw(s) of the subject.
Obstructive sleep apnea (OSA) is the most common type of sleep apnea and is characterised by repeated episodes of complete or partial obstructions of the upper airway during sleep, despite the effort to breathe, and is usually associated with a reduction in blood oxygen saturation. In the Obstructive Sleep Apnea-Hypopnea Syndrome, the episodes of decreased breathing are called “hypopnea” and its definition requires a ≥30% drop in flow for 10 seconds or longer, associated with ≥3% oxygen desaturation. The episodes of breathing cessations are called “apneas” and to be defined, a ≥90% drop in flow for 10 seconds or longer must be assessed and associated with ≥3% oxygen desaturation, or an arousal.
Orthognathic surgery ; also known as corrective jaw surgery or simply jaw surgery, is surgery designed to correct conditions of the jaw and face related to structure, growth, sleep apnea, TMJ disorders, malocclusion problems owing to skeletal disharmonies, or other orthodontic problems that cannot be easily treated with braces. Originally coined by Harold Hargis, this surgery is also used to treat congenital conditions such as cleft palate. Typically during oral surgery, bone is cut, moved, modified, and realigned to correct a dentofacial deformity. The word "osteotomy" means the division, or excision of bone. The dental osteotomy allows surgeons to visualize the jawbone, and work accordingly.
Uvulopalatopharyngoplasty is a surgical procedure or sleep surgery used to remove tissue and/or remodel tissue in the throat. This could be because of sleep issues. Tissues which may typically be removed include:
The genioglossus is one of the paired extrinsic muscles of the tongue. The genioglossus is the major muscle responsible for protruding the tongue.
Maxillomandibular advancement (MMA) or orthognathic surgery, also sometimes called bimaxillary advancement (Bi-Max), or maxillomandibular osteotomy (MMO), is a surgical procedure or sleep surgery which moves the upper jaw (maxilla) and the lower jaw (mandible) forward. The procedure was first used to correct deformities of the facial skeleton to include malocclusion. In the late 1970s advancement of the lower jaw was noted to improve sleepiness in three patients. Subsequently, maxillomandibular advancement was used for patients with obstructive sleep apnea.
A mental spine is a small projection of bone on the posterior aspect of the mandible in the midline. The adjective mental in this instance is used in its "chin-related" sense rather than its more common "mind-related" sense. There are usually four mental spines: two superior and two inferior. Collectively they are also known as the genial tubercle, genial apophysis and the Latin name spinae mentalis. The inferior mental spines are the points of origin of the geniohyoid muscle, one of the suprahyoid muscles and the superior mental spines are the origin of the genioglossus muscle, one of the muscles of the tongue.
Jaw reduction or Mandible angle reduction is a type of surgery to narrow the lower one-third of the face—particularly the contribution from the mandible and its muscular attachments. There are several techniques for treatment—including surgical and non-surgical methods. A square lower jaw can be considered a masculine trait, especially in Asian countries. As a result, whereas square lower jaws are often considered a positive trait in men, a wide mandible can be perceived as discordant or masculine on women, or sometimes in certain men, particularly when there is asymmetry.
Mandibular fracture, also known as fracture of the jaw, is a break through the mandibular bone. In about 60% of cases the break occurs in two places. It may result in a decreased ability to fully open the mouth. Often the teeth will not feel properly aligned or there may be bleeding of the gums. Mandibular fractures occur most commonly among males in their 30s.
Maxillary hypoplasia, or maxillary deficiency, is an underdevelopment of the bones of the upper jaw, which produces midfacial retrusion and creates the illusion of protuberance of the lower jaw. It is associated with Crouzon syndrome, Angelman syndrome, as well as fetal alcohol syndrome. It can also be associated with cleft lip and cleft palate. Some people could develop it due to poor dental extractions.
Sleep surgery is a surgery performed to treat sleep disordered breathing. Sleep disordered breathing is a spectrum of disorders that includes snoring, upper airway resistance syndrome, and obstructive sleep apnea. These surgeries are performed by surgeons trained in otolaryngology, oral maxillofacial surgery, and craniofacial surgery.
Hyoid suspension also known as hyoid myotomy and suspension or hyoid advancement, is a surgical procedure or sleep surgery in which the hyoid bone and its muscle attachments to the tongue and airway are pulled forward with the aim of increasing airway size and improving airway stability in the retrolingual and hypopharyngeal airway. The horseshoe shaped hyoid bone sits directly below the base of tongue with the arms of the bone flanking the airway. Hyoid suspension is typically performed as a treatment for obstructive sleep apnea (OSA). This procedure is frequently performed with a uvulopalatopharyngoplasty (UPPP) which targets sites of obstruction higher in the airway. Typically, a hyoid suspension is considered successful when the patient’s apnea-hypopnea index is significantly reduced after surgery.
TransOral Robotic Surgery (TORS) is a modern surgical technique used to treat tumors of the mouth and throat via direct access through the mouth. TransOral Robotic Sleep Apnea (TORSA) surgery utilizes the same approach to open the upper airway of patients with obstructive sleep apnea. In TORS and TORSA procedures, the surgeon uses a surgical robot to view and access structures in the oral cavity (mouth) and pharynx without any incisions through the neck, chin or lip. Current TORS techniques include radical tonsillectomy, resection of palate and base of skull tumors, hemiglossectomy and resection of tumors above and involving the larynx. The TORSA technique is used for uvulopalatopharyngoplasty, hemiglossectomy, and other airway procedures.
