Mandibular Distraction – An Effective Treatment Option for Obstructive Sleep Apnea

Mandibular distraction is a proven treatment for obstructive sleep apnea (OSA), the condition characterized by obstruction of the upper airway which leads to episodes of disordered breathing during sleep. OSA occurs due to obstruction in the flow of air in to the lungs and is characterized by repetitive pauses in breathing and loud snoring. Complete/partial blockage of the airway during sleep may happen due to a variety of reasons

  • Enlarged tonsils and adenoids
  • Small size of the lower jaw
  • A deviated nasal septum
  • Nasal congestion
  • Narrow airway passages
  • Enlarged tonsils
  • Weak pharyngeal muscles
  • Vocal cord injury

Both children and adults can be affected. Common symptoms include:

  • Mouth breathing
  • Difficulty awakening
  • Excessive daytime sleepiness
  • Hyperactivity/behavior problems
  • Restlessness during sleep
  • Daytime fatigue and sleepiness
  • Frequent infections
  • Sleeping in odd positions
  • Snoring

Correction of OSA with Mandibular Distraction

A plastic surgeon with special training and experience in reconstructive procedures can provide optimal results for mandibular distraction. The surgeon will study the patient’s medical history, including his or her X-ray reports and medication list to devise a customized treatment plan. The procedure involves the following stages:

  • Creation of an incision inside the mouth to cut the mandible or lower jaw bone on each side
  • Creating an osteotomy (break) in an abnormal bone
  • Attaching a device known as a distractor to both sides of the break
  • Adjusting the distractor should over a period of time until the break gets stretched to fill with new tissue

Once the bone is in the desired position and held in place, the regenerated tissue is allowed to heal and develop into new bone. When the gap is filled with the new bone the distraction procedure is complete. To prevent the jaw from collapsing, the distractor and its connecting pins are removed only after the new bone formation is hardened.

Ideal for Patients Non-compliant with CPAP Therapy

Distraction osteogenesis is ideal to manage OSA in individualswho are non-compliant with continuous positive airway pressure (CPAP). The CPAP breathing machine pushes air into the airways with intensities and pressures that are adjustable. It comes with a tube connected to a mask that is placed on the patient’s nose. The mask is tightened by straps behind the head. The main problem is that many people have difficulties using CPAP as machine and mask could be bothersome, bulky, and restricting. This makes it difficult to wear all night or every night

Due to its advantages, mandibular distraction has become a popular surgical option over conventional orthognathic surgical procedures. Successfully performed, the procedure improves breathing. The oxygen level of the blood increases, which in turn, corrects sleep disorders and behavioral problems, and improves brain functioning.