How Successful is Surgery for Sleep Apnoea?

Understanding the words 'Success' and 'Cure' in sleep apnoea surgery is frighteningly difficult as there are 9 different definitions for these terms. In this video I explain what is meant by a 'successful' operation or 'curing' someone of sleep apnoea with surgery. I want to reduce the confusion about these terms and I hope you find this video useful if you are thinking about surgery for sleep apnoea. This video is all about Maxillomandibular advancement surgery (MMA) surgery for sleep apnoea.
Article I reference in this video: pubmed.ncbi.nlm.nih.gov/26606...
The image I used this video was from Souresh Zaghi's website - I gained his approval beforehand. www.zaghimd.com/surgical-options
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** Disclaimer - The information in this video is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace a consultation with your own doctor/health professional. **
Chapters
0:00 Introduction
3:12 Improvement rate
3:48 Sher Criteria
6:25 Off CPAP rate
7:21 As good as CPAP rate
9:06 Sleep apnoea cure rate
11:03 UARS - upper airway resistance syndrome
12:22 'Cured' rate
14:37 Complications and risks of MMA surgery
17:59 Conclusion

[@robertp.wainman4094]

Thank you so much for your excellent videos - you explain so well and we viewers learn so much.

[@samgreen7294]

Tremendous work Dr. Veer. I seriously considered this until I was diagnosed with complex sleep apnea. I am new to an ASV machine and my numbers are very, very good. I am far less foggy and looking forward to rebuilding my personal reserves.

[@samanthapierce9466]

Thank you so much!! I’m having a functional rhinoplasty /septoplasty w/ mass excision and endoscopic sinus surgery in a couple of weeks. I have severe sleep apnea, and I use my CPAP every night! Your videos have been extremely informative and helpful!! Thank you again!!! ❤❤❤

[@andrewevans8456]

Great video! Thanks so much fir explaining it so well

[@tez6693]

Dr Veer, your work is consummate quality.

[@iseeyou1312]

I think the meta-analysis could be somewhat misleading in that a lot of the older studies would be based around smaller movements (often

[@VikVeerENTSurgeon]

I'm glad you've had a good result and I hope others have similar results. Currently I believe that this remains the best and most up-to-date meta-analysis available. If it is updated I will do this video again.

[@shuikai272]

@@VikVeerENTSurgeon I also agree the metastudy is very good. Also check out "A one-arm surgical trial of obstructive sleep apnea (OSA) patients before and 12 months after Bilateral Internal Ramus Distraction of the mandible (BIRD)", that one is also very useful.

[@jobovens6949]

Great and respect what you are doing.

[@VikVeerENTSurgeon]

Many thanks, glad to was useful

[@morm2173]

DR Veer is one of my favorite ENT Rhinologists

[@mytuube11]

This is amazing. I wish there was more info ike this available to laypeople. Also 40 kinds of surgery for apnea? That means this dr really finds the source and ww realy need more of this ❤

[@shuikai272]

A lot of the "bad sleep apnea MMAs" seem to be around the 2-6 mm range for the mandibular osteotomy site. A lot of surgeons do advancements like that. At that point you're really better off doing some other surgery, or seeing another maxillofacial surgeon (assuming you are sufficiently recessed) who knows how to do a better job.

[@Abdul12_34]

Hi dr veer, thanks for seeing me and looking forward to more of your videos 💪💪💪💪😊😇

[@VikVeerENTSurgeon]

Looking forward to seeing you too

[@lightningandthunder2861]

Its scary doesn’t sound like it is worth it

[@lcowan5046]

Great video and absolutely LOVE the honesty regarding the surgery, cure rates and realistic expectations. I am not in the UK and the NHS did not do my MMA surgery. My surgery was done in Bogota, Colombia (I am American but live here) on 25 September 2022 (30 days ago). If you or anyone has questions, please drop me a line. Of course I can only comment on what my surgeon told me before the surgery and what I have experienced since my MMA surgery.

[@kanzaahmad5746]

How were you feeling before and after the surgery

[@yahyaelmi8435]

Did it improve the sleep issues ???

[@yahyaelmi8435]

Guy says if you have any questions drop dm and disappears

[@JesseNerio]

Beautifully done video. I have been studying sleep apnea and it's treatments. You have helped me so much, thank you!

[@VikVeerENTSurgeon]

My pleasure, glad it helped

[@Blu-Man]

@@VikVeerENTSurgeon greetings new to channel if u see his want to inquire on a video u done very very long ago

[@Janecas]

Hello Dr. Veer, I’m in love with your channel. I have learned a lot with your channel, which I’m adapting to my day to day life, like facial exercises and how to correctly use a nose spray. I suffer from Non Allergic Rhinitis, which I find very challenging and annoying to handle. If you ever miss inspiration for a new topic for a video :-) maybe an interesting topic for a video? thank you for work and dedication for the better welfare of everyone.

[@yahyaelmi8435]

Hey you need to get a sleep study and a dice

[@dr.k.vogel.]

@@yahyaelmi8435what do you mean "a dice"?

[@dr.k.vogel.]

Do you have apnoea as well? I have moderate-severe OSA and pretty bad rhinitis, I've often wondered if they are connected - maybe because a narrow airway means that air is travelling faster than usual in and out of the airway and causing irritation a the back of the nose. @VikVeerENTSurgeon

[@furiousdoe7779]

Wow Vik , thanks for the excelent explenation . Had i sweaty night again upper chest twice ... I think is has to do with breathing . I almost never have it during travel i an tent though ..strange ..

[@VikVeerENTSurgeon]

perhaps you are allergic to house dust mite?

[@furiousdoe7779]

Thanks for the response ..could be , I will check it out if I can find where.

[@benjamindeforest9363]

No one is breaking my jaw

[@joemax_kiamco]

Are there any side effects of a dental appliance, if so what are those, how can we avoid it?

[@Bandit-137]

I have been struggling with Sleep APNEA for a few years now. I have had terrible luck with CPAP to the point that it aggravates my inner ear and has caused major pressure/possible inflammation behind and around my eyes. Sadly my Dr says this is not possible and that my APNEA is too mild but it has happened multiple times now and has done something to cause severe light sensitivity. The light sensitivity has gotten so bad that I had to leave the job I loved and am on long term disability now. Since stopping CPAP three months ago my light sensitivity symptoms/inner ear issues have slowly improved. Sadly my sleep has not. I often wake up after a few hours with my pillow and head drenched in sweat. I have a sore jaw sometimes and woke once with a locked jaw. I plan to have my tonsils removed, I have tried an oral device for 3 month with mixed results (my light sensitivity never went away with it) and I lost a lot of weight (getting down to my normal weight) before leaving my job but did not see any major improvements. Any advice would be highly welcomed. Thank you.

[@yahyaelmi8435]

Hello sorry to hear I am a Dr I would like to guide you send me your WhatsApp I have done a lot of research on sleep apnea and UARS

[@preetimittal2123]

Now how are you?

[@kwesson4439]

Hi, is UARS treated on the NHS? I watch all your videos.

[@VikVeerENTSurgeon]

Yes, it is. At least it is at the RNENT where I work

[@LaughinLoneStar]

Not all MMA surgeries are created equal. Under advancement because of limits of technology have always been a huge problem. Now it is possible for better advancements because of 3d custom per patient printed titanium plates along with their respective guides. Total game changer. For those folks with average size jaws, or "normal" MMA probably won't do much good. But if you have the small jaw deformity that many do, it's probably going to help you greatly. And remember, a genioplasty is usually done along with MMA, which raises the success rate.

[@dinobambino21]

Could you do more videos about UARS? I'd like to know why it's not a well-known condition, and how somebody can get help for it.

[@VikVeerENTSurgeon]

Have you seen this one? kzbin.info/www/bejne/qZKcq4GPpbmKoq8

[@user-gm7xi8gs6j]

I've been watching you non-stop for a couple of weeks now Vik. I think I have sleep apnoea. What would you recommend as the first steps to find a cure for it?

[@travv88]

First step if you think you have it is get a sleep study done to confirm if you have it or not.

[@Matty72UK]

Hi Mr V. Silly question. I'm one of your patients, you've done my turbinates. I'm scheduled for double tonsillectomy and palatiplasty next. With a supine AHI of 60 and total of about 30 what sort of ball park improvement could I expect? I spoke with another patient and he said his improvement, after tongue base RFA was amazing. It's encouraging!

[@yahyaelmi8435]

Hello how was your turbinate reduction surgery ? Did you do the other surgeries? Q

[@yahyaelmi8435]

How was your turbinate reduction

[@emailvinayasap]

Dr. I am Dr. Vinay from India. Could i get on a call with you.. i am sleep Apnea Patient and needed some critical advice..

[@silverdentalcentre6374]

Surgery is always a last resort and this is a very complicated surgery with a very challenging recovery. Why not recommend surgical expansion or even simple orthopaedic expansion with dental appliances? I treat patients with those regularly and have my own as well.

[@yahyaelmi8435]

Our health line guidance in the UK is poor , but we do have great drs

[@richardroyal9841]

Had surgery obstructive sleet apnea.Prior SAT 73. Sleep study Awoke 317 times, 60 seconds zero breath…nurse light blue. SurgerySuccess. SAT 95 +++ How. LASER cut out excess tissue back throat. A pathway breath brain…had over grown tissue. Clear path way. Success!

[@preetimittal2123]

Now how are you did you sleep peacefully ? And please mention the name of your surgery

[@cathy9814]

Can I ask you two questions? Why does my left jaw hiss when I chew and why do my ears click a pop constantly? Thank you so much

[@VikVeerENTSurgeon]

Hard to tell, might be a perforation. Ask your GP to look in your ear, they will probably be able to work it out.

[@cathy9814]

@@VikVeerENTSurgeon well the ent put and ear tube in my ear he thought I had fluid in my ear I had none the whole from the tube would not heal I had to go to an another specialist and this is the third patch she has put on it it is down to a pin size whole now. So that may be it

[@simoley1]

Is it possible to have the same results with braces , I had septoplasty and turbinate reduction 2 weeks ago, the op was a success but I’m still waiting to see any results in improvement with sleep apnoea, I don’t have a cpap machine as it was not working when I had a deviated septum, I’m looking at going back and getting a mandibular device but now wondering if I change my overbite with braces would this help and have the same result as a MMA Thanks again , if it wasn’t for your videos I would have never figured out my septum was deviated

[@preetimittal2123]

How r u now?

[@derSchlaueMann]

Have had MMA surgery last year and still suffering from positional sleep apnea (AHI of around ~14 lying on my back while lying on the side it’s less than 5). That’s why I wear a snoring backpack every night (besides a tape that keeps my lips closed). With these both I have a good sleep. However, I wouldn’t consider myself ‘cured’. Surgery went very well though. Planning on getting septum deviation surgery next. (For information: have an athletic body and in mid thirties.)

[@VikVeerENTSurgeon]

Sounds like you are nearly there - keep going!

[@trevorcullinane6420]

Hi , I have the same problem as yourself, athletic not over weight, got my ahi down to 5 on my side and 10 on my back , have a mandibular device and side sleeper backpack but not cured , going to try excite osa which is supposed to work on tongue base problem. Hopefully this works for me

[@sanemonk1]

@@trevorcullinane6420 hi I am in the same place as you. 68 ahi down to 14 after surgery. What's excite osa? Can you explain please.

[@preetimittal2123]

​@@sanemonk1which surgery??

[@iDTecKt]

Why doesn't my CPAP make me feel better? I have severe around 50 per hour, my Sleep doctors tell me i also have nearly 30 arousals per hour to and i dont enter stage 3 of the sleep cycle, but they cant tell me why, Please try to give me an answer/reason for this? my whole body is exhausted and im pretty much bed bound daily, nearly 43 years old

[@Will-xf3qe]

I see plenty of patients that don't get any deep sleep (N3). Kids have the most N3. old people usually have none.

[@thomasputko1080]

Im AHI 53. How do I get the surgery on NHS?

[@VikVeerENTSurgeon]

Just ask your GP to refer you. There should be a MaxFax service close by

[@thomasputko1080]

@@VikVeerENTSurgeon just on last Thursday I was told by ENT doctor that this surgery is not covered by NHS... Update: it turns out to be misunderstanding. Dear doctor was talking one surgery I was talking another. He was talking about cutting soft tissue I was talking the mandibular surgery. Silly.

[@dr.k.vogel.]

I am due to have MMA/Bimax on the NHS, but it has taken many years and many appointments with private surgeons to find out what the (hopefully) correct surgery is and to get referred to a team at the JR in Oxford. I was initially referred to the RNENT by my GP to a surgeon who doesn't do bimax/mma and it was only by going private that I found out about mma. @@thomasputko1080

[@reardelt]

But MMA changes your side profile. It changes your aesthetics

[@haelienicole]

Usually for the better