As you can see on the diagrams (yes the words are in French but you can get it without the words, can’t you?) and video below, the airway is confined by the upper and lower jaws and the spinal column. When this space (the airway) is too narrow, like during sleep when muscle relax, sleep apnea starts.
By moving the upper jaw (maxilla) and lower jaw (mandible) forward, the entire airway can be enlarged. On the 2 X-ray below, you can see my airway before and after.
That said be aware that the way an x-ray is taken can change the airway size. I added at the bottom of the page, an x-ray before the surgery taken by another surgeon. The difference, between the above one and this one is significant and it is for the same person…
If the size of the airway is one thing to take into account, but there are other factors that need to be taken into account to decide on the best option. For example, even if I had a pretty low AHI of 21, I needed more than 15 cm / H2o with the CPAP to get an effect. Sleeping with such high pressure was not comfortable and hard. Being also pretty thin and the fact that I needed this high pressure where some indicator in favor of MMA. In fact it meant that my throat soft where pretty thin and so that a surgery would open the airway with a very high chance that it will not collapse.
The animation below describes what the surgery is trying to achieve. This animation is for surgery related to jaw mis-alignment and not especially maxillomandibular advancement (MMA) done to cure sleep apnea, but the principles are the same.
So in a MMA, both the upper jaw (maxilla) and lower jaw (mandible) are moved forward as shown on the 2 schemas below (source: sleepaneasurgery)
Before Surgery
After Surgery
There are even youtube videos about this type of surgery! These videos are not showing the latest techniques used, according to my surgeon, but the principles are the same.
A video of the upper jaw surgery (sensitive souls abstain)!
A video of the lower jaw surgery (sensitive souls abstain)!
To conclude, the 2 front x-ray, before and after, on which you can see the forward move, the titanium plates and screws, as well as braces (or arch bars).
Before Surgery
After Surgery
Below are some more x-rays of my airway taken at different time and in different surgeon office. The differences between this x-ray and the above one is significant, so be aware…
The below images are from a kind of scan (I-CAT). The left picture with the green line indicates at which level the right picture, which is a view from the top, was taken. The back volume in the middle of the right picture, is the airway.
Airway at the soft palate level, before surgery
Airway at the hyoid bone level, before surgery
