Posted by: @toomer

I can read the stats from about 75 patients that have had the DOME procedure done at Stanford ... they report an average reduction of AHI of 53%: https://www.sciencedirect.com/science/article/pii/S1389945719301881

I've got to be honest ... having a significantly improved airway and nasal breathing in just 30 days ... has quite of bit of appeal to it (even though there's 11 months of a diastema and braces to deal with afterward).  But with a lab-diagnosed severe OSA AHI of over 40, if I end up with an "average" result of 50% improvement ... I will still have moderate sleep apnea.  So I'm wondering if anyone here had it done, and can report on their experiences of airway increase?

 

I have done something similar in a couple of patients. In reality it's a SARPE without the pterigomaxillary disjuntion done surgically (but done through the screwed expander).

But it is better not to do the horizontal cut, that way there is an larger increase of the nasal airway.

You know, doctors like to invent acronyms...

Where are you from, by the way?

@sergio-oms

I'm from the Washington, DC area.

Yeah, keeping up with all the different acronyms - DOME, RPE, MARPE, MSE, etc. - is tricky.

Were your patients suffering from OSA, and if so - how much airway improvement did they receive as a result of the procedure?

@toomer

I did not study any possible breathing disorder, the patients still needed the expansion due to occlusal reasons, they were referred to me for that. I offered them a home sleep test with a validated device but they refused.

Has anyone here had a consultation with either Dr. Stanley Liu or Dr Audrey Yoon in regards to DOME? 

@toomer

I’m assuming you decided against the DNA appliance? What happened in your consultation about that?

@mr-sand-man123

I wouldn't say "ruled it out" ... but some of the concerns here about how it works, were giving me a little bit of pause.

But then the TMJ/OSA specialist that I started with (who is a DNA provider) made it clear that we won't be discussing any airway expansion protocols ... until we get my TMJ under control.  So I've got about 3-5 more months of occlusal bite splint therapy ahead of me ... and already I can tell that my jaw is moving.  In just 2 weeks my molars went from making contact on both sides of the splint, to just one side (so we keep grinding it down bit-by-bit apparently to try to level out my bite).  

If when all of that is done and my jaw is (hopefully) in it's "preferred resting position" ... if it looks like my airway problem is mostly due to inadequate lateral width ... I probably would consider DOME now (and I found a local provider that can do it).

@toomer

Interesting. I wonder if I could benefit from that splint therapy. I have a cross bite and narrow palate, which I think is contributing to sleep disordered breathing. I’m leaning towards the DNA appliance but I’m interested in anything that could help. I’ve started to feel very slight feelings of tension/pain in my jaw joint as well but nothing severe...but it’s just one more thing that is pushing me towards doing something about it.  What exactly is that splint doing for you?