High blood pressure. High cholesterol. Chronic fatigue. These symptoms and more can be signs of untreated sleep apnea. “Given that obesity has gone up substantially in this country, a lot of patients are suffering from undiagnosed sleep apnea. It’s not necessarily caused by a higher BMI; it could be an anatomical issue as well,” says Dr. Reza Movahed, a surgeon at Oral Facial Surgery Institute & Implant Center. “They’re dealing with all these symptoms—or if they are diagnosed, they have to go through the huge lifestyle change of having a CPAP, which is a device that keeps them breathing at night.”
For these patients, a new surgical option—advancement and counterclockwise rotation of the occlusal plane—moves the jaw to create a larger airway, often with better medical and aesthetic results than traditional surgical methods, Mohaved says. He studied the technique during a fellowship with Dr. Larry Wolford at Baylor University Medical Center in Dallas, and is not aware of any other surgeons in the Midwest who perform this procedure. “We pinpoint (a patient’s) problem and we’re able to address it in one surgery,” he says.
This surgical option creates a permanent result for patients, as opposed to the lifestyle change that a CPAP entails—which includes wearing the facial equipment every night and packing it with you every time you travel, Movahed notes. “The airway has a proper opening, and they will never have to worry about it again. For people who have a CPAP and are not complying with it, as well as those who are misdiagnosed or have had the wrong procedures done for them, this would help correct their problem.” In addition to resolving their sleep apnea, he adds, “Majority of patients, within 6 months after surgery, require lower doses of their blood pressure medication, or none at all. This should be augmented with good diet and exercise, as well.”
When patients come in for a sleep apnea-related procedure, Movahed begins with a thorough and comprehensive evaluation of the airway. “With virtual surgical planning, we have the ability to do the surgery ahead of time on the computer, and create a profile so we can give the patient improved facial harmony,” he says. “Everything is very cutting-edge about what we do.”
The evaluation also is based on a CT scan, clinical evaluation, and evaluation for possible TMJ (temporomandibular joint disorders), which could impact the stability of the jaw, he says. “It’s like the foundation of a house: We check what kind of structure we’re dealing with. We have to make sure everything is stable and we’re building on a good foundation. That’s why we do a comprehensive evaluation of everything—we take the big picture into account to make sure there will be a good outcome.” Recovery for the procedure typically is about two to three weeks, and the outcome and recovery time are improved for younger patients, he adds.
Movahed practices at Oral Facial Surgery Institute & Implant Center’s Chesterfield office, which specializes in sleep apnea procedures, TMJ and corrective jaw surgery. “Our nurses are adapted to our patients’ needs, and they know how to take care of these patients post-operatively.” The practice has three additional locations—at Mercy Hospital, and in Kirkwood and Eureka—which all specialize in oral and maxillofacial surgery.
On the Cover: Oral Facial Surgery Institute & Implant Center’s six physicians specialize in oral and maxillofacial surgery, treating conditions of the teeth, mouth, jaws and face. Pictured on the cover: Drs. Michael Noble, Patrick Morris, Michael Barbick, Mykle Jacobs, Reza Movahed and John Haden. For more information, call 251-6725 or visit ofsinstitute.com.