Adventures in Cranial reconstruction

We are all mutants. From that initial, inexplicable spark of life so many billions of years ago, all life on earth flows. Had there been no mutations, we would still be that same primeval life form that sprung from the slime. But with each subtle change of the genome over the countless years since then, life on Earth has become more and more diverse. I'm a mutant, she's a mutant, and you're a mutant, the product of billions of mutations that add up to you.

Some mutations are fatal, and offspring so born do not last long. Other mutations are only subtlety fatal, and may take years to manifest. C has a mutation in a gene that would otherwise protect her from cancers of the breast and ovaries. Because of this mutation, she's much more likely to suffer these maladies.

The mutation that I speak of today is also subtle. I have inherited a structural flaw in my skull that significantly restricts my breathing airway. I cannot sleep at night, as my airway collapses, slowly strangling me in my bed. If I didn't wake up each and every time I fell asleep, I'd choke, and never see the sunrise.

I have obstructive sleep apnea, and my apnea score is now 70. It was over 100 when we first explored how to reduce its impact on me. This means that I wake myself up 70 times an hour in an attempt to breathe. Needless to say, I don't sleep well.

The reduction in my score from 100 to 70 has been achieved through surgery. My first surgery was a procedure called uvulopalatopharyngoplasty, commonly (and justifiably) shortened to UPPP. As part of this procedure, my uvula and tonsils were removed, and a bit of reconstruction of my nasal passages was performed. This wasn't enough. My second surgery was a genioglossus advancement with hyoid suspension. For the first part, a hole was cut into my jawbone, and a screw was implanted, pulling the bone, and by extension the tongue, forward.

For the other part of this surgery, the hyoid bone was disassociated from the structures that hold it in place in the throat. The net result of these surgeries was to reduce my sleep apnea score from 100 to 70. Anything over 10 is considered severe.

So I still have a problem, and there are two more surgery options remaining to me. I'm getting ready for a procedure called Maxillomandibular Advancement. Essentially, my upper and lower jaws are going to be disassociated from my skull, and bolted into place in such a way as to optimize my bite and airway. The video makes it look all so easy.

The last step of surgery is a tracheotomy, and I don't believe that I'd like this very much. I can only hope that step 3 will work well enough to make step 4 unnecessary.

This page is authored and maintained by Rich Webb.You can send E-mail to me by following this link to the contact page. And feel free to contact me if you have any comments, criticisms, or suggestions. I remain, however, perfectly capable of ignoring your useless opinion...

This document was last modified on June 9, 2010, and has been viewed countless times.