How do I look today ?
Actually, I look worse, but I’m sure it’s the funny angle of the picture. The glasses tell you I’m back online and in fact I did some searching on this operation: let’s start with the inevitable Wikipedia page on Obstructive Sleep Apnea and to finish off, a nice animated flash movie from the Mayo Clinic site explaining how the operation is performed.
So here is my understanding about how it works:
- after they put you out, the face tissues relax, and they stretch your mouth open
- ligaments to the skull surfaces are severed along the root of your gums all around your mouth, freeing up your lower face from connection to the skull bones
- upper lip is pulled all the way up to expose the base of you nose
- upper jaw bone (maxilla) is cut horizontally above the teeth roots; there is very little muscle on the bone when you “lift” the face, so this not as invasive as it sounds
- upper lip is pulled back in, but not sewn
- lower lip is pulled all the way down, overturning around the chin, exposing the lower jaw completely. I find amazing that human tissue is so elastic, but think of from where those big babies are born…
- as you see in the animation, the lower jaw (mandibula) can be now cut, this time vertically on both sides, right after the last set of molars. This second cut is done again where there is little, if any, muscle which is instead remaining on its natural anchoring position at the root of the mandibula
- you now have both jaws more or less free to move from the rest of the skull; I’m guessing now, but I think the surgeon now inserts little screw-wedges in the cracks, precision adjusting the position of the severed pieces away from the rest and versus each other to perfectly match the desired bite and to ensure maximum trachea gauge; this is not just ANY position as the maxilla and mandibula are traversed by the respective nerves, which are flexible parts, but not very longitudinally elastic; you can pull them, yes, but only so far, and the pulling is what will cause the numbness to be expected in the following weeks as nerves adapt and grow new cells
- once this best position is achieved, the metal crowns are fixed and wired, the mouth is shut in place (so this is why they needed to force vent me from the nose I guess)
- titanium plaques are screwed on the mandibula, while for the maxilla four grafts are enough – all of these could be removed once the bone has healed, but I see no reason to renounce to what are now the most eternal parts of my body !
- wedges can be removed
- chin plastic is performed (a small resin chip is screwed to the outer hyoid bone)
- lower lip is pulled back to its position, both lips are sutured back where they belong (my surgeons would not tell me how many stitches they had to do, they preferred to talk about “one very long stitch going all around”)
- septoplasty and turbinate removal is done
- airways are freed, patient is awakened
Good morning, Gianni !