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Sleep Surgeon Question 38

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Question 38 - Is it possible to have long term pain with MMA?

From: D.

Dear Doctor,

I am 29 years old, slightly overweight but not much, and suffer from both sleep apnea and atrial fibrillation. It has been implied that sleep apnea might be the cause of my a-fib, especially since I am quite a bit younger than many with a-fib.

I have tried CPAP and UPPP/Septoplasty, which gave me a lot of improvement but I still have mild sleep apnea.

I am strongly considering an MMA, but am concerned about the possibility of long-term pain/headaches stemming from the surgery. Is this concern justified?

Thanks for your time,

D.

Response Provided by Dr. Kasey Li
May 21, 2008

There is a correlation between sleep apnea and arrythmia. Most sleep physicians and cardiologists will recommend aggressive treatment of sleep apnea. Although MMA is an option, you will certainly need to balance the benefit/risk ratios.

Long term headahes following MMA is uncommon, actually I have not heard of patients with long term headaches. Patient with sleep apnea often have headaches and MMA usually helps headaches. Long term pain (lip, palate, teeth, jaw) is possible, but rare. In my personal experience of 600+ MMA, I have had two patients with TMJ pain after surgery. One patient had complete resolution of her TMJ pain and another is currently going through physical therapy and pain therapy. It may take 6-8 months to resolve the symptoms. Nerve or teeth pain can occur, but is again, rare. I had two patients with this type of symptoms. One has upper teeth pain of about level 3 (scale of 0-10), another one has small amount of lower lip pain.

I don't usually going into much detail of this type of problem because it is so rare, but anything can happen with surgery. The individual needs to look at risk/benefit ratio before any treatment.

Kasey Li, MD



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