Jaw Bone Surgery — Yes or No?

My jaw is misaligned. Two orthodontists recommend getting a dentofacial osteotomy: breaking the jaw bone to extend it. I don't notice any inconveniences right now, but these may come in the future, although neither orthodontist could say what the chances are. They still recommend the procedure, I think it's mostly based on 'getting it right' and avoiding any complications.
There are no reported cases of this procedure having any impact on one's hearing.

Should I go for it?

 

There are risks when it comes to the Jaw and T.
Multiple doctors told me that there are several things that a dentist/dental surgeon can do that can worsen your T or give you one...these are: having your mouth stretched wide open for a long time (bones pressing against ears), injecting too much anestethics, severing the ear nerves which run below the teeth, using too much leverage when pulling the tooth resulting in structural shift of the face nerves.
Sure, the chances that something will happen are slim...Still, I would be careful when it comes to worsening the T.

I would consider the surgery when you have acute problems/pains. Is there no "soft approach" like wearing a custom made splint to correct your jaw?

 

I've been postponing my decision, but I've got to decide sooner or later. So, I've dug up my old thread, hoping for new advice

The surgeon said that they never had any reports of effects on someone's hearing. He suggested that I'd speak about it with a psychologist, but I've been waiting for an actual appointment for over 6 months...

Pros:
- getting my jaw in the right position to avoid trouble later on,
- getting a symmetric face,
- being able to chew properly,
- 2 orthos and 1 surgeon recommend the procedure

Cons:
- could possibly mess with my t, although no reported cases apparently (my t does respond to extreme jaw/neck movements, and temporarily spiked after a previous, much 'lighter' surgery),
- 10% chance of a change in feeling around my lower jaw,
- i really need to graduate as soon as possible and can't afford any delays caused by complications,
- i am already dealing with a ton of other stuff / don't trust my decision making skills too much now.

Options:
1) have the surgery in summer 2016
2) postpone and have the surgery sometime after graduating. (Get braces again, takes longer, higher costs, results may not be as good as doing it now),
3) postpone and possibly never have the surgery.

What would you do?

I'm really, really having a hard time with this, so any comments are very much appreciated!

Thanks for the reply... sorry I'm kind of late to respond. I also think that there is a relation, I'm not sure why the dr's tell me that there have been no reports.
Even braces with bone-anchors couldn't fix my jaw, so only surgery will work now.

 

I would go with your instinct ,
I have a jaw problem and may need surgery too.
Got to see the radiological specialist for the third time and see what he wants to do.....lots of love glynis

 

My 2 cents. Don't do the surgery or at least hold off as long as possible. I started my journey with bilateral joint surgery, moved into braces (7 1/2 years they were on). Next I had an upper pallet expansion surgery. Then I had the lower jaw advancement...... This resulted in numerous issues and complications including facial nerve damage. Next I had another bilateral joint surgery and 4 short years later I am looking at another one. Through all of this, I have had issues with T as well. I have good days and bad days. I have accepted this as my life and have not had any success with completely getting rid of it. If I had all my surgeries to do over again, the lower jaw advancement one would not have been done!


I too was told by every doctor that came into close proximity of my face that I needed the advancement surgery. I do not see a huge difference in facial symmetry and the recovery / eating through a straw (AGAIN) was not worth it. Not to mention, most insurances will not cover the procedure, resulting in 10's of thousands of dollars out of your pocket.

I was extremely apprehensive heading into that surgery and almost didn't go! In hind sight, I truly wish I had turned the car around and went home! I'm not trying to scare you or talk you out of something you feel you need to do, just really think about it and go with your gut!

We are all different and the surgery may be a great success for you, which I truly hope, for me it caused more problems than it solved.

Best of luck to you and hope you find relief soon!

 

I've been delaying this decision for far too long now... but I'll have to decide this week

My instinct says that it's probably better to undergo surgery and avoid complications later on.
My father hasn't taken care of his teeth very well and sometimes suffers from pain in his face that no doctor can seem to diagnose or resolve. I certainly don't want to have the same problem. There are risks, but my T seems to come from noise exposure and none of the dental work I've had seemed to have any lasting influence.

How are you? And how is your jaw problem? I hope all is well!

 

How does this manifest itself , I have these annoying clicks in the left side of my jaw when I speak , super annoying.

 

I would take the advice of your medically trained professionals. if you're concerned after a first and second opinion, I'd go and get a third one. Surgery is nothing to take lightly. No one on this site has the requisite medical training to make a decision for you about this surgery, nor do anyone on this site know the real particulars of your specific case as to why these orthodontists are recommending surgery. If you're really still concerned that surgery might not be the right solution, talk to another medical professional.

 

Hi @walkthroughwalls,
I went to see the Maxillofacial specialist and said I would be a good candidate for surgery but said with in 18months it will need doing again as said it does not last long.
The cartilage keeps coming out of place both sides and cracks badly with the cartilage popping in and out and have lost some distance in how far my jaw will open.
He wants see me again in six months to see if want go for surgery or wear a mouth guard 24/7.

Still not sure what to do as the operation does not sound to positive.
Would like to hear from people who have had surgery and if it helps.

He says I have bone damadge in the jaw joint but not enough for new joints..lots of love glynis

 

@Tmjsurgeryqueen !! I'm so sorry I'm this late with my reply Especially because it seems that you have only registered to reply to my post... I've been feeling absolutely miserable for the last months, and hardly have had the energy to do anything...

Thank you for sharing your story. I'm sorry to hear the surgery hasn't worked out for you at all Could you say something about why the surgery was needed in the first place? Did one of the surgeries cause tinnitus, or did your tinnitus react to the surgeries, or are these two separate problems?

My story seems to be a little different than yours so far. I 'only' need to have my extended on one side and possibly split in the middle to widen or narrow it (can't remember which >_<). One operation and I'm done. The risk of damage to the facial nerve is there (10% chance of damage). Practically all costs will be covered by the insurance.

How are you now? I hope you're well!

 

Wow, there are more replies coming in than I can respond to! Don't hold back, though. I appreciate it very much!

I have a slightly asymmetric face and I can't chew/grind my food properly. Those are not ideal, but not the worst thing in the world either. The biggest issue is that the misaligned jaw may cause the joints to wear out quicker and put extra tension on facial muscles, causing all kinds of hard-to-resolve problems later on.

My jaw will click if I open it at a certain position, but it only really happens when I'm deliberately trying to do that.

Thanks. I generally agree with what you've said, but I do value the opinions of those in similar situations as well
Of course, those who successfully underwent surgery are less likely to end up on a board for tinnitus sufferers, so there's that as well.

It's too late for a third opinion, but the first and second were exactly the same, the surgeon's opinion matched those as well. All three seemed competent professionals to me.
Only my dentist seems to think otherwise. He thinks these type of surgeries are all a sign of the times we live in, this modern age of the Socially Engineered Society in which we strive for the perfect appearance blah blah... But he's more or less the one who got me into this mess in the first place by ignoring the problem, not telling me of the risks and options, and only sending me to an orthodontist when it was too late and I hardly had options...

It sounds like there is hardly a definite answer as what's best to do, and it's hard to see what choices will have which consequences.

If choose to go the surgery route, I'll have mine in the beginning of July. I can then let you know how mine went.

 

Interesting you should mention it. I was considering double jaw surgery before my onset of T, now that's placed way on the back burner. One thing I wonder about is the conductive sound as they are cutting or breaking your jaw. How loud is it really?

Good luck with whatever you decide and let us know how it goes.

 

@walkthroughwalls ,
Hope you go on well with your surgery and keep me posted on how you are doing....lots of love glynis

 

Tiny update:

I went to the hospital yesterday. My original surgeon has fallen ill and won't be able to work for months. I talked to another surgeon who said that they perform this type of surgery twice a week on average and never have they seen any influence on a patient's hearing. And that included patients with ear-issues.

As I result I decided to undergo the procedure and have been put on the waiting list. I will meet a surgeon again in two months, because they want to check on me and my situation. I'm terribly depressed and dealing with the surgery and recovery may send me even further down...

 

Great. I support your decision. I think you are doing the right thing. I wouldn't dwell on the downside. A major problem like that needs to be dealt with.
Try thinking of it this way: you are doing the only reasonable thing that anyone could do in your position. Rest in that. If this were poker, you would be right to push your chips all-in. It doesn't mean anything is certain; just that the odds are in your favor. Let the chips fall where they may and don't bring it up again to reassess it. Find some enjoyable things to do and maybe get some assistance with your mental health problems.

 

Walk through walls I totally understand how you feel and in the same position jaw wise.

Are you on antidepressants or had talking therapy ?....lots of love glynis x

 

Thanks. One thing, though: it isn't a major problem. Which is what makes the decision so difficult. Without the surgery dental problems 'may or may not' arise in 10+ years... If I knew for sure that there would be problems, there would be no choice and I would opt to undergo surgery immediately.

Your thoughts still apply, though. I totally agree
Surgery seems to be the decision with the highest 'chance of success', so that's where my chips are. I've made the best decision I could with the information available to me at this time. Now, I won't look back, and no regrets

Not on anti-depressants. I have a horrible experience with those. Also, these drug companies have done a lot of selective publishing (only publishing favorable lab results), which makes me very wary to have anything to do with them. I will reevaluate if things don't pick up, but for now I'd rather aim at counseling to address my problems directly.

Speaking of which... I just had a terrible experience at the psychologist's and feel absolutely miserable now. Maybe I should dig up my other thread to discuss this.

 

An update, for those who care. I will have my operation on Monday the 18th of July. Wish me luck!
If anyone has any questions about this type of surgery, please ask! I'll be glad to try to help.

Other things: still low energy, feeling miserable, depressed, and still no psychological help after 9 months of intakes and testing. Relationship with my parents still isn't great. I still like computer science, but hate the messy school I go to. I was on the verge of being forced to leave school, but I passed the required courses and can now continue. I'll be heavily in debt when I'll get out, though.
My tinnitus is slightly louder than usual, probably because of the neck pain I have from all that screen work. I'm trying to resolve this by going cycling and walking, but I can barely kick myself out of bed in the morning.

And so I continue... a life not worth living and yet not bad enough to throw it all away.

 

I'm getting a couple of red flags...

First they said they'd plan the procedure the summer vacation. Months later I get a phone call: "We have a date for your operation, it's in the middle of September." Later on, it was moved to this Monday after all. If it wasn't I'd not planned anything for my entire vacation for nothing and would have had to delay the operation by a year.


Then this happened in the last talk at the hospital:

Surgeon: So, we'll widen the upper jaw...
Me: ...not narrow the lower jaw?
Surgeon: *checks computer* *scratches something out on a apiece of paper* Ah yes, we'll narrow the lower jaw.
Me: Okay

Today my `liquid food' came in the mail, for after the operation. The dietician said it would be vegan, and it isn't


Is this normal behavior for a hospital? It's not enough to completely call off the procedure, but damn... I'm putting my face on the line here

 

Hey, I saw your post and decided to give you "just" my opinion.

Well, people need to think that "any surgery" shouldn't be taken easy.

And we're talking about jaw surgery. You say that it isn't a major problem. Do you suffer from pain? Why do you need to do this?

I saw an othodentist last year before all theses T issues. Just wanted to make my teeth more aligned (Btw I have beautiful teeth ;-)) and the dentist told me to make this jaw surgery cause I wouldn't have enough place to let my teeth move with the braces. He told me the same thing as you, today you're feeling good but you may have pbs around 40 bla bla... He told me to think about it. For me it was obvious, surgery? No way. And I don't regret my decision.

I saw a therapist more than a month ago, who was alledgedly specialised in inner ear, tinnitus etc.. to find some relief for my T. He made some moves with my jaw... It was horrible. I had facial pains and burnings, couldn't open my mouth, couldn't sleep, my neck was blocked, couldn't eat, vertigos, extreme headaches OMG.. Thanks God, I am well now but this was hell for about a month. I made researches on the internet about TMJ problems and what could help and all say that jaw surgeries are very delicate and try to postpone if there's really no choice.

Please consider it, maybe you won't have problems and I'm wrong but I think that people underestimate jaw surgeries. And surgeons are always in, they need to work. LOL.

It is your life of course and like said before, try to seek another medical advice when you're not sure. And you don't know what's going to happen in 10 years.

Good luck!

 

Hi @walkthroughwalls,
Sorry to hear your scheduled opperation will not take place till September after building yourself up to it.
How are you feeling ?hope your low mood has lifted or getting some support for it to help you as know how that feels.
I think I told you I don't need the opp since having a partial denture after 34 years of poor dental work miss inlined my jaw and TMJ now gone after all them years with pain and crunching.

Hope you can make some last minute Holliday plans.
I work in a school and break up for 6 weeks on Friday and looking forward to it and will be going away with hubby a few days already planned.
Stay positive and hoping all goes well for you....lots of love glynis

 

Thank you so much for your opinion!

Now I'm doubting whether I should do it again, although it is a little late now :/

I have no significant pain and the teeth themselves look quite okay, if I may say so myself . But my lower jaw is misaligned and I can't chew properly. I can definitely feel a little tension in my cheeks. And my father, who hasn't taken care of his teeth very well), has facial pain 24/7 which no doctor can explain or cure.
Two orthodontists and two surgeons recommended the procedure because the operation rarely results in complications and the risk of long-term problems is there. The surgeon had never seen any effect on anyone's hearing. And so, after months of deliberation, I went along.

May I ask how your therapist moved your jaw that caused it so much trouble?
I can only get an increase in tinnitus if I turn and stretch my neck so that my head touches my shoulder, but I have no reason to actually do that in daily life
My tinnitus is probably noise induced (loud rehearsal with earplugs) and does not come from anything `physical'. Although, after a previous surgery on my teeth I had really loud tinnitus for a week that completely went away afterwards.

I also think that there's a connection between the facial muscles/bones (TMJ) and tinnitus, but there's hardly a specialist in The Netherlands that will confirm that, let alone one who's able to say something specific about it. The surgeons I have seen so far, have not seen any effect on tinnitus. So I may only hope that I won't be the first.

Hey Glynis

Sorry, maybe I didn't express myself very well The postpone-thing was the first phone call I received. Weeks later, they called that they did have a date during the summer holiday. I will be operated upon on Monday July 18th. Or in other words, in three days

Glad to hear you don't have to have an operation So, all your pain is gone now?
Have fun on your holiday!

 

@walkthroughwalls ,
Wishing you all the best for Monday and will be thinking of you.
Sending you a big hug.....lots of love glynis

My jaw pain has gone

 

No pain, that's fantastic!
And thanks for thinking of me


@Nonna Did you remove your message? I was trying to quote it, but then an error message appeared... I was going to respond, but if you'd rather have it removed, then that's okay too

 

I'm probably just going to end up blowing off steam here, but okay...

Today I came back from the hospital. The surgery went perfectly, I recovered quickly and my tinnitus is roughly the same. Only my cheeks are have swollen a lot, so I look like a hamster-human-hybrid.

The surgeon and most staff were all very friendly and professional, although there was the occasional nurse who hesitantly first tries to pull your knickers down and afterwards tries to explain why that was necessary


Then there's diet. I'm vegan and trying out new dairy-based foods right after an operation is not a great idea. Well, here we go: first I'm sent a whole box full of non-vegan `liquid foods'. If hadn't checked the ingredient lists and started e-mailing, I would have food poisoned myself. The same dietician gave me a list of suggested foods to throw into a blender. All of them are traditional Dutch meat-based recipes and a couple of non-vegan meat/fish-substitutes.
Interestingly, they consider the Dutch fish and chip shop-style snack 'kroket' vegetarian, which it clearly isn't
(let alone healthy...)

The morning after the operation I'm brought some kind of vegetarian porridge of unknown origin for Mr. FlyThroughDoors. Cool, they got the food and name wrong
Then I'm presented with all kinds of non-vegan meal-choices for dinner, and no-one there knows what exactly is in the food the serve or what the possibilities are. Thankfully, I recovered quickly and was allowed to go home in the morning. When I left, they gave me three packs of tomato-vegetable stock to make and drink at home. The exact stuff which the dieticians list recommends me not to drink, because it's all water and flavour, and has no nutritional value.

At the risk of sounding arrogant, I really don't understand how I can be sharper on four doses of morphine than the staff who were told my dietary restrictions weeks in advance. Has anyone seen that part of The Lion King where Scar says "I'm surrounded by idiots... " ? That's how I feel sometimes...


And now I'm home with my parents, who both were against the operation. Actually, it's partly because they decided against an operation when I was eleven that I have to go through this now, in order to save what can be saved.
My father has been giving me bad vibes for weeks no and communicates a little as he can get away with.

My mother really wants to help with the best intentions, but she ends up pulling things out of my hands insisting that she'll carry them, talking to medical staff for me and about me while I'm standing right there. Occasionally she'll come into my room and start an argument (again) over whether the window should be closed or open. Note: I'm completely capable of walking around, expressing myself, showering, opening doors etc.

Today she made me some food that was against my suggestions. I tried it and it was so salty I couldn't eat it. I told her and apologised, and then she gets upset She really has the best intentions, is incredibly considerate and she has a heart of gold. But these things happen, and she takes is personally... and here I am dealing with the recovery and these two social minefields


I can't wait to get back to school where I can just get pissed of at the professors and their messy lectures and random grades

 

Hows the recovery going?