Indicates sessions with Audience Response Systems (ARS) or Poll Everywhere available
Indicates sessions that require a ticket for attendance
Indicates Practice Management and Allied Staff Sessions Day Pass.
Indicates sessions with recordings available for purchase.
Patients with obstructive sleep apnea have been treated in the past with a phased treatment plan approach. Phase I consists of conservative therapy such as Uvulopalatopharyngoplasty. Patients who failed phase I would be approached with a more invasive phase II procedure such as maxillomandibular advancement or tracheostomy.
Patients who undergo Phase I procedures make maxillomandibular advancement challenging due to changes in the soft tissue anatomy which can restrict advancement.
We have developed a new treatment protocol to manage the obstructive sleep apnea patient. Patients are first diagnosed with obstructive sleep apnea with a polysomnography study. Once OSA has been diagnosed the patient is placed on a continuous positive airway pressure device to treat the disease. Those patients who cannot tolerate CPAP and wish to explore surgical options undergo a drug induced sleep endoscopy to evaluate the levels of obstruction. Patients either qualify for the Inspire upper airway stimulator or MMA surgery.
MMA surgery is done with a mandible first approach using virtual surgical planning. This allows deviation from the traditional 10mm advancement of the maxilla and mandible. It allows more autrotation of the mandible and is more aesthetic to the patient.
Patients who undergo Phase I procedures make maxillomandibular advancement challenging due to changes in the soft tissue anatomy which can restrict advancement.
We have developed a new treatment protocol to manage the obstructive sleep apnea patient. Patients are first diagnosed with obstructive sleep apnea with a polysomnography study. Once OSA has been diagnosed the patient is placed on a continuous positive airway pressure device to treat the disease. Those patients who cannot tolerate CPAP and wish to explore surgical options undergo a drug induced sleep endoscopy to evaluate the levels of obstruction. Patients either qualify for the Inspire upper airway stimulator or MMA surgery.
MMA surgery is done with a mandible first approach using virtual surgical planning. This allows deviation from the traditional 10mm advancement of the maxilla and mandible. It allows more autrotation of the mandible and is more aesthetic to the patient.
References
Robert W. Riley, DDS, MD, Nelson B. Powell, MD, Christian Guilleminault. Obstructive sleep apnea syndrome: A surgical protocol for dynamic upper airway reconstruction: Journal of Oral and Maxillofacial Surgery.51:742-747,1993.
B.D Tiner, DDS,MD. Surgical Management of obstructive sleep apnea. Journal of Oral and Maxillofacial Surgery. 54:1109-1114, 1996.
Scott B. Boyd, DDS, PhD, Arthur S. Walters, MD, Yanna Song, MS and Lily Wang, PhD. Comparative effectiveness of maxillomandiular advancement and uvulopalatopharyngoplasty for the treatment of moderate to severe obstructive sleep apnea. Journal of Oral and Maxillofacial Surgery 71:743-751, 2013