Do I have to live with sleep apnea?

Obstructive sleep apnea has wide-ranging effects on your quality of life as well as your health. This condition, in which patients repeatedly stop breathing for brief episodes during sleep, interferes with your body’s ability to rest. Furthermore, sleep apnea appears to have a correlation with very serious health problems like high blood pressure and stroke.

Understandably, patients who believe that they may have sleep apnea often seek treatment for the condition. When that treatment is successful, the patient benefits from feeling more well rested and getting a health boost, as well.

Patients, who have noticed health signs of sleep apnea, like morning headaches or a sleep apnea surgeon or another sleep specialist to get a conclusive diagnosis should evaluate daytime drowsiness. This is the first step toward successful treatment and relief from sleep apnea symptoms.

Take Dr. Wolford’s Airway Questionnaire for Obstructive Sleep Apnea (OSA).

Additionally, the sleep apnea surgeon must determine what structural abnormalities are causing the apnea. Obstructions in the nasal passages can cause patients to have difficulty breathing during sleep, while the problem may be with the position of the jaw or excessive soft tissue at the rear of the throat in other patients. If the soft tissues are able to go slack and cover up the airway opening, that will cause pauses in breathing, too.

Many patients will initially undergo a conservative approach to sleep apnea treatment. In fact, a sleep apnea surgeon may not even need to perform an invasive procedure to give the patient relief.

If those conservative measures are not effective, however, the sleep apnea surgeon may explore other options, such as a surgical procedure to correct a congenital defect in the jaw structure or the nasal passages that may be contributing to the problem. Surgery can also be performed to address issues specifically with the soft tissues.

Patients who suffer from sleep apnea can get effective treatment. If you have questions or would like to schedule an appointment, please contact Dr. Larry Wolford’s office using our online contact form or call 214-828-9115.

Condylar hyperplasia (CH) is a generic term describing enlargement of the condyle.  There are a number of different condylar pathologies that enlarge the mandibular condyle, with subsequent adverse effects on the morphology and function of the TMJ and mandible.  This may result in the development or worsening of a dentofacial deformity such as; mandibular prognathism (symmetric or asymmetric), and unilateral enlargement of the condyle, ramus, and body, facial asymmetry and malocclusion. 

Wolford has developed a simple, but encompassing classification that will allow the clinician to better understand the nature of the various CH pathologies, progression, and treatment options that have proven to eliminate the pathological process and provide optimal functional and esthetic outcomes.  The classification (Table 2 and Figure 29) also begins with the most common occurring form of CH and progresses to the least common occurring form.

CH Type 1:  This condition develops during puberty, is an accelerated and prolonged growth aberration of the normal condylar growth mechanism, is self-limiting but can grow into the 20’s, and can occur bilaterally (CH Type 1A) or unilaterally (CH Type 1B).

CH Type 2:  These condylar pathologies can develop at any age (although 2/3s develop in the 2nd decade), are unilateral condylar vertical and/or horizontal over-growth deformities, and are the most common occurring mandibular condylar tumors; osteochondroma (CH Type 2A) and less common osteoma (CH Type 2B).

CH Type 3:  These are other rare benign causing condylar enlargement. 

CH Type 4:  These are malignant conditions that can cause condylar enlargement.

The more common forms of CH (Types 1 and 2) will be presented relative to the clinical and radiographic findings, growth characteristics, effects on the jaws and facial structures, histology, and treatment considerations that are highly predictable in the elimination of the pathology and provide optimal treatment outcomes. 

FIGURE 29 Description

A-C) normal TMJ with balanced joint spaces.
D-F) CH Type 1 with relatively normal condylar shape, elongated condylar head and neck, and narrow joint space related to thin articular disc or displaced disc.  In the coronal view the condylar head is more rounded.
G-I) CH Type 2Av; an osteochondroma with a vertical growth vector without significant horizontal condylar enlargement or exophytic horizontal growth. This is a “young” osteochondroma with only about 3 years of growth.
J-L) CH Type 2Ah; an osteochondroma with horizontal (as well as vertical) enlargement of the condyle and exophytic outgrowth of the tumor. This tumor has been present for 6 years. Notice the significant increased vertical height of the mandibular body and ramus.

FIGURE 29