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QUESTION: I have a severe case of sleep apnia, and I have arrived at a fork in the road. I feel it is now time for this surgery. I currently am sleeping with a bi-pap machine 12/18 with a oral appliance. I use a chin strap to keep my mouth closed, and 3 other straps to hold my full face mask in place I am very constricted. My head and face are getting sorer by the day.
I have heard that Dr. Kasey Li. in Stanford Ca. is the best at these procedures. I checked out an interview on google with him on this procedure. He sounds very good. He said that he has done over 1000 of these surgeries. He also states that I should look for a surgeon that does 2 to 4 of these procedures a month. He also stated that I should ask for the doctors past patients to talk to about their experience.
Currently I have seen a Maxofacial oral surgeon in Wisconsin. He stated that he has only done 100 of these surgeries total. On the other side of the coin he has performed 60 to 70 a year of the orthognathic surgeries for 20 some years stating that it is the same surgery.
My question is: Is there a difference between these two surgeries that I should be aware of?
Should I use the doctor that I have found in Wis. or should I go see
Dr. Kasey Li in Ca.?
Do you know of any great Maxofacial surgeons in the Chicagoland area that specialize in just Sleep apnia cases?

Thank you for being available to answer these questions
Sincerely,
Kevin

ANSWER: Kevin -  Let me tell you that I am not personally familiar with surgeons in the Chicago area.  After doing a little research, I have discovered that one surgeon, Dr. Mark Steinberg, a Board Certified Oral and Maxillofacial Surgeon, seems to have extensive experience in doing the surgery you seem to need.  

Dr. Mark Steinberg - Northbrook, Ill - (847) 272-9516

So contact Dr. Steinberg for an evaluation.  After seeing him, you can decide which doctor you wish to have treat you.  I wish you well and hope it all goes well for you.

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QUESTION: Thank you for your answer and your research.
I will look into this other dr.Steinberg
I still would like to know if there are any differences between the two surgeries or are they the same just called different names.

ANSWER: Kevin - the facial and jaw changes that precipitate sleep apnea is not the same in all.  For that reason, it is a little difficult for me to just define the surgical corrections as two.  Some surgeries advance the lower jaw.  Other advance the lower and reposition the upper jaw.  Some surgeries include nasopharynx surgery.

No doctor does only one type to correct this situation.  If so, then the doctor is restricted by his knowledge and not ready to look at the true cause.  So you need a surgeon who has extensive experience.  I don't know the surgeon in Wisconsin, but Dr. Steinberg seems to have extensive experience and has both a dental and medical degree.  You need to be comfortable with the doctor.  So speak with both doctors and feel comfortable and confident in the doctor you choose.

If you have additional questions, feel free to contact me again.

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QUESTION: Thank you again Dr. Teig.
I have a few other questions to your last response.
I looked up nasopharynx surgery and that seems to be a surgery for cancer. What surgery are you referring to? The nasopharnyx is the region at the base of the tongue correct?
The surgery that Dr. Sewall in Wisconsin at Froedert medical in Wisconsin is going to do  moves the lower jaw forward 10 mm, and then, move the upper jaw 10mm to match it. This is not a counterclockwise rotation surgery.
So if it the surgery that i just explained isn't it just like the orthagnathic operation?
I contacted Dr. Steinberg and he wants to give a counsel appt. before he answers any questions. His secretary stated that his specialty is not really the sleep apnia surgeries being the maxilmandibular advancement but more towards reconstructive surgeries orthagnathic in general.
He is also out of network for me.
Have you ever heard of My doctor in Wisconsin Dr. Sewall at Froedert med ?
If not do you have any other recommendations.
Thank you again,
Kevin

Answer
Kevin - First, Dr. Sewall is a board certified oral and maxillofacial surgeon.  As such, this type of doctor is the type that I feel is appropriate.  

As far as the nasopharyngeal surgery, that is the type of surgery to assist in the  correction of sleep apnea by Ear, Nose and Throat doctors.  Theirs is a different type of approach.

There are also some doctors who do not treat this situation with surgery at all.  There is a prosthetic appliance worn by the patient at night.

I personally do not know of other doctors, but if you chose a major medical center, like the Mayo Clinic there should be a number of doctors associated that should have appropriate experience.  Likewise, Columbia Presbyterian Hospital, New York City, Massachusetts General Hospital or Cleveland Clinic should all have doctors who are knowledgeable and skilled.  

I wish I could be more specific and give you additional doctors, but I personally do not know of more.  I wish you well and hope whoever helps you gets you better.  

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Joel S. Teig, DMD, Diplomate ABOMS, retired

Expertise

I am a board certified oral and maxillofacial surgeon and I am available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.

Experience

Board Certified Oral and Maxillofacial Surgeon practicine for over 20 years. Assistant Clincal Professor and State University School of Dentistry.

Organizations
American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

Education/Credentials
BA -University of Connecticut DMD - University of Pennsylvania School of Dental Medicine

Awards and Honors
National Honor Society (OKU), Philadelphia County Dental Society, Mosby Book Award, Oral Surgery Honors, Summa Cum Laude

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