After Facial Surgery, Tammy Says Goodbye to Years of Sleep Apnea

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After Facial Surgery, Tammy Says Goodbye to Years of Sleep Apnea

By
Joel Streed

January 17, 2020

Before coming to Mayo Clinic, Tammy Olson had been told the severe obstructive sleep apnea she'd been living with for years was beyond treatment. After meeting Christopher Viozzi, M.D., D.D.S., a Mayo Clinic oral and maxillofacial surgeon, however, Tammy found the help she so desperately needed.

Tammy Olson was at the end of her rope physically and emotionally. Years of living with the worsening symptoms and effects of severe obstructive sleep apnea had taken their toll on her life, her family and her marriage.

To make matters worse, after failing to respond to continuous positive airway pressure, or CPAP, therapy and traditional sleep apnea surgical treatments, a local specialist was at a loss for what to do next. "After evaluating me and seeing just how bad things were, he said, 'I'm sorry, but there's nothing left we can do for you,' and then just sent me back home," Tammy says.

Tammy knew the dark reality of what that dismissal meant for her. "My apnea was so bad that I'd stop breathing for up to 30 seconds at a time," she says. "I knew my organs couldn't go on living without oxygen for that long forever. Eventually, over time, I knew this would likely kill me."

That realization triggered mounting stress and anxiety for Tammy, and during a follow-up visit, she conveyed those fears to her primary care physician. Her physician's response was compassionate and clear. "After telling her how upset I was about everything, she said: 'Don't worry. I'm going to send you to Mayo Clinic,'" Tammy recalls.

Cautiously pessimistic

While grateful for the opportunity to get a second opinion, Tammy wasn't immediately optimistic. "When I was referred to Mayo Clinic, I wasn't overly hopeful based purely on everything I'd already been through and had been told by my local care providers," she says. "I was scared that doctors there were just going to tell me the same thing: that nothing could be done to help me."

Tammy's husband, Mike, was equally dubious. "Before Tammy was referred to Mayo, we were at the last crossroads of trying to figure out just how many more years of life she had left and what to do with that time," he says. "We went to Mayo being very skeptical of any other medical professional being able to help her."

Despite the doubts, Tammy and Mike made the drive to Mayo Cl i nic in Rochester to meet with Christopher Viozzi, M.D., D.D.S., an oral and maxillofacial surgeon. Within 10 minutes of sitting down in his office, their outlook changed. "When I walked into Dr. Viozzi's office for the first time, it was almost like he immediately became a part of our family," Tammy says. "He made us feel so at ease right off the bat and told us, 'We're going to figure this out, and we're going to do it together.'"

"When Dr. Viozzi told Tammy, 'We can fix this for you,' we both started bawling right there in his office. It was the first real hope we'd been given in a long, long time."
Mike Olson

Their physician-patient teamwork began with Dr. Viozzi ordering a series of imaging tests to examine Tammy's airway and see if there was an obstruction that was causing her sleep apnea. After reviewing the images, Dr. Viozzi didn't find an obstruction, but he did see that Tammy's airway and nasal passages were abnormally narrow. As he continued studying Tammy's imaging results, a surgical fix that Dr. Viozzi had performed many times before came to mind.

"It became pretty clear that we could help her with skeletal surgery to reshape her facial bones and her head and neck structure that's supporting her airway," Dr. Viozzi says. "That's the surgery we proposed to do for her."

Though the surgery would be invasive and complex, Tammy and Mike wasted no time in agreeing to it. "When Dr. Viozzi told Tammy, 'We can fix this for you,' we both started bawling right there in his office," Mike says. "It was the first real hope we'd been given in a long, long time."

Apnea erased

Before their hope could turn into healing, Dr. Viozzi and his surgical team would need to surgically reshape and reposition Tammy's facial structure.

"What we're doing during this kind of surgery is moving all the bones below the eye sockets forward," Dr. Viozzi says. "The surgery indirectly moves the soft tissue forward by moving the bones forward. The midface bones are moved forward, and that in turn pulls the soft palate and lateral sides of the throat forward and opens up the airway at that level. The lower jaw and the chin are then both brought forward, as well. That brings the tongue and the tongue base and the larynx up and forward. "

It's a complicated, time-consuming procedure that's conducted with extreme care and precision. "It's a big, big surgery," Dr. Viozzi says. "The facial bones are carefully sectioned away from the skull base area, slid forward, and then held in place by small titanium plates and screws. Then over the course of six to eight weeks, the body will come in and lay down new bone, at which point the patient is healed."

For Tammy, while healing after surgery did take some time, the results were apparent right away. "Once I had the surgery, there was some recovery, of course, but I experienced immediate results," she says. "And when I went back to Mayo for a sleep study nine months after the surgery, my apnea was gone. My sleep scores were back to normal. That was just so amazing after everything I'd gone through before coming to Mayo Clinic."

New peace of mind

As her recovery continued, Tammy found herself back in Dr. Viozzi's care at one point when she experienced acute discomfort on the right side of her jaw. "I sent him a message through Mayo's patient portal app about six months after my surgery, saying that something was going on with my bite and that it just didn't feel normal anymore," Tammy says.

Dr. Viozzi promptly scheduled another appointment for Tammy. During that appointment, he ran several tests and discovered that the temporomandibular joint on the right side of Tammy's jaw had deteriorated. This development wasn't a complete surprise.

"She had symptoms of this going on prior to surgery, and those symptoms accelerated after the surgery. So we then had to do a second fairly complicated operation, which was a total joint replacement of her right temporomandibular joint with a new ball-and-socket joint," Dr. Viozzi says. "She's unfortunately had some problems with that, too, but we've kept chipping away at it, and we've got it pretty close to where she needs it to be now."

"How do you accurately repay someone for giving you your life back? Because that's exactly what Dr. Viozzi and his team have done for me."
Tammy Olson

Despite the setback, Tammy and Mike say they'll remain forever grateful to Dr. Viozzi and everyone else at Mayo Clinic who's had a hand in Tammy's care. "How do you accurately repay someone for giving you your life back?" Tammy says. "Because that's exactly what Dr. Viozzi and his team have done for me. I'm sleeping normally again and back to doing everything I was doing before all of this started. The way that Dr. Viozzi and his team cared for us and treated us was something we'd never before experienced in the medical field. They provided such peace of mind throughout our entire ordeal, which I think is an important part of the healing process."

The improvement in her quality of life that Tammy now enjoys is just one example of the significant effect Dr. Viozzi and his team often see after treating patients for obstructive sleep apnea.

"Patients with severe obstructive sleep apnea by and large are seriously debilitated by this condition. The impact on their lives cannot be overstated," Dr. Viozzi says. "We've had patients who couldn't work in their chosen occupation because they were always tired, and it was just too risky, who could not return to work they enjoyed, and patients who could no longer drive because they would fall asleep at the wheel who bought new cars after their disease was addressed. Having a hand in that is very gratifying for our surgical team here at Mayo Clinic."

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