04/22/2026
Anna came to Movahed OMS at 19. Her TMJ pain was getting worse. Her chin was receding down and back into her neck, and her bite had shifted to the point where her teeth no longer came together properly. Chewing was difficult. Closing her lips took effort which was causing her to become a habitual mouth breather.
An MRI showed both jaw joints were breaking down. The condyles, the rounded ends of the lower jaw that connect to the skull, were deteriorating. This is called condylar resorption. It is progressive. Without intervention, the joints continue to break down, the bite continues to shift, and the airway continues to narrow.
A CBCT scan measured her airway at 73 mm² at its narrowest point. The average is 140 mm². She was breathing through a space about half the size it should be. Think of it like breathing through a straw instead of a healthy airway.
To find out exactly where the obstruction was, Dr. Movahed performed a Drug Induced Sleep Endoscopy, or DISE. During DISE, the patient is sedated and a small camera watches the airway collapse in real time. It shows the surgeon precisely where and how the airway is closing.
Anna's tongue base was falling back and blocking the airway completely. Her oxygen saturations dropped to 77%. A healthy patient sits at 95% to 100%. Anything below 90% is considered dangerous. At 77%, the brain and organs are not getting the oxygen they need.
Dr. Movahed performed Total Joint Replacement on both sides, a LeFort 1 Osteotomy to reposition her upper jaw, and a Genioglossus Advancement to pull the tongue base forward and open the airway.
One year after surgery, Anna is thriving.
She can open her mouth 41mm. That's wide enough to eat a sandwich, yawn, and laugh with her mouth wide open without worrying about it. She is pain free, her joints are functioning properly, her bite is aligned. Her breathing is optimized and she is enjoying restful and restorative sleep.
