Frequently Asked Questions (FAQ)

Yes, the cause of obstructive sleep apnea is always organic. This means that there is a narrowing somewhere in the anatomy of the airways. In the vast majority of cases, this narrowing is caused by a recession of one or both jaws. Therefore, to cure obstructive sleep apnea, one must surgically move the jaws forward.

Almost always. Only in people who no longer have their own teeth in the jaw (full dentures), the operation can be performed without orthodontic co-treatment. Often, however, a new full denture is needed after the operation.

Unfortunately, the statutory health insurance only covers part of the costs. Depending on the health insurance fund and insurance, the cost coverage varies.

There are studies on this. In 90% of cases, patients find themselves more beautiful or unchanged beautiful after the operation. However, 10% do not find themselves quite as beautiful as before the operation.

As a rule, the operation lasts between 2 and 3 hours and is performed under general anesthesia.

The complete operation takes place in the oral cavity. Since the mucous membranes heal very quickly and usually without scars, no scars are seen in the oral cavity.

In most cases, patients who have already undergone surgery report only a little pain. Pain can be well reduced by analgesic medication. The swelling of the face after the operation is somewhat unpleasant, but can be relieved well by permanent cooling with cooling devices.

Snoring arises for the same reason as apnea itself. If the cause of sleep apnea is eliminated, then this will also eliminate the cause of snoring.

As a rule, you will be on sick leave for about 4 to a maximum of 6 weeks.

Since a kind of gap is created in the upper jaw during sleep apnea surgery with rotation, a special vascular transposition must be made during the surgery to ensure blood circulation. Because of this gap, which is built up with the patient's own bone, the resting time is much longer than with normal jaw advancements. Therefore, chewing should be avoided until the treating physician gives clearance after an X-ray. As a rule, this is 3-6 months.

After the operation you should avoid all contact sports. All sports where there is a risk of getting a blow / ball / other in the face must be avoided. Sports that generate vibrations (cycling, vibration plate, jogging) or where clenching is necessary (weight lifting) should also be avoided. Crosstrainer or home trainer bicycle are already possible after 3-4 weeks.

The swelling varies in intensity and length from patient to patient. Usually, large swellings are gone after about 2 weeks and everything looks normal.

Due to the braces and the associated elastics, which are supposed to keep the bite together closed after the operation, you have to get used to the new situation at the beginning. As a rule, you can speak a little more unintelligibly directly after the operation, but after about 2 weeks you will have gotten used to it and can speak normally again.

The costs for the initial consultation including the necessary X-ray images are usually covered by statutory and private health insurance.

Sleep apnea is causative for several life-threatening diseases, including hypertension, diabetes, myocardial infarction and stroke. The literature usually refers to all-cause mortality and all-cause morbidity.

Three META studies between 2010 and 2018 were able to prove that a cure rate (AHI below 5) of 38.5% - 44.2% was achieved by an ordinary bimaxillary advancement. The ISTAT Institute for Applied Statistics took a close look at the 2019 Seagarten Clinic numbers and confirmed an 86.8% cure rate through Dr. Frey's advanced procedure. 100% of patients operated on at SeegartenKlinik in 2019 no longer require therapy. AHI below 15.

After sleep apnea surgery, you can eat only mushy and liquid food. Very soft foods such as mashed potatoes, baby jars, scrambled eggs very soft boiled pasta, etc. are fine to eat. Please refrain from chewing at all costs.

Piezosurgery is a new, ultrasound-based, particularly gentle surgical technique for bone mobilization (also used, for example, in sinus lifts ). The ultrasound waves transmitted by the piezo device mobilize only solid tissue and do so without sharp blades (scalpel). This technique reduces the risk of nerve and blood vessel injuries to a minimum. The nerves are not cut.

As a rule, the waiting time for a consultation appointment is approx. 4-8 weeks. The waiting time for a surgery appointment is about 4-8 weeks after the consultation appointment.

You should come to Heidelberg for a follow-up check-up every week for 3 more weeks after discharge from the clinic. From this point until the titanium plates and screws are removed (approx. 6-9 months later), you should come for a check-up once a month.

Yes, you may. We also strongly recommend it.

We always take a lot of time for the consultation. Please allow sufficient time for the first consultation. On average, the consultation including all necessary X-rays, photos, intraoral examination, etc. takes about 2.5 - 3h.

At the consultation appointment, the following is done:

• X-rays: Cephalometric lateral radiograph, OPG, temporomandibular joint radiograph.
• Intraoral examination
• Investigation of the cause of sleep apnea in your case (where is the constriction, are you eligible for rotation advancement surgery?)
• Special and very detailed anamnesis
• Education about the connections between sleep apnea and its secondary diseases
• Clarification about the surgical technique
• Preparation of medical letters and cost estimates

The risks of sleep apnea surgery by jaw surgery are manageable. The most common are inflammation (about 8% of cases), temporary (up to 1 year) numbness of the chin and palate, the clenching of the teeth can shift after the operation, so braces are used at the same time. The titanium plates and screws can be bent or break under stress, so you must strictly follow the doctor's instructions and not chew for a long period of time.

The procedure and the associated shifting of the jaws stretch the nerves. Therefore, you must expect temporary numbness in the chin area and on the palate. The feeling in these areas usually returns after 2 weeks, but it can take up to a year until the complete feeling is back.

According to the guidelines of the DGSM (German Society for Sleep Medicine), the chances for a cure (AHI below 5) of sleep apnea with a pure forward displacement of the jaws are about 38-44%. By pre-displacement with rotation, we were able to achieve a proven cure rate of 86.8% at SeegartenKlinik in 2019. (ISTAT Institute of Applied Statistics). At SeegartenKlinik, 100% of the operated patients could be released from the CPAP mask (AHI below 15).

A guarantee for a cure of a disease may not be given by law (and rightly so). Nor is there any legal claim to a cure , since in some cases this cannot be achieved even with the best treatment. What we can guarantee is qualified and careful treatment according to the accepted rules of medical science and compliance with professional standards in patient care.

They are usually hospitalized with us for about 6 days after the operation. During their stay, a nurse and a ward physician on duty with years of experience in emergency medicine are always present. The attending surgeon is also always on call and appears several times a day for rounds. In addition, we have central monitoring of vital signs (blood pressure, pulse, oxygen) in every room.

Since in most patients the initial diagnosis was several years ago, we perform a new sleep laboratory examination without any therapy before surgery under inpatient conditions and with the emergency physician present. In this way, we have documented the ACTUAL condition before the operation and possible deteriorations or improvements compared to the previous findings.

Worldwide, the specialist literature assumes approx. 1000 operations. In the United States of America, there are about 250 operations per year. We at the SeegartenKlinik operate between 70 and 120 people with sleep apnea per year. Conversely, this means that about 10% of the worldwide bimaxillary advancement surgeries take place in our clinic.