From the Neck Up: An Exceptional Surgeon Does it All

What do sleep apnea, dental implants, jaw cysts and wisdom teeth have in common? The answer is Dr. Ryan Williams. He’s Chief of Sleep Surgery in the Department of Otolaryngology and Head & Neck Surgery and of Surgery in the Division of Oral & Maxillofacial Surgery at Weill Cornell Medicine. He’s that rare healer who bridges two major specialties, and he wouldn’t have it any other way. 

Within otolaryngology, Dr. Williams treats complex sleep disorders. As an oral and maxillofacial surgeon, he treats facial fractures, jaw cysts and temporomandibular joint (TMJ) pain, among other conditions. He also performs dental procedures under IV sedation such as biopsies, wisdom teeth extractions and dental implants.  

Originally, he wanted to be a sinus surgeon, and that is indeed part of the mix of surgical treatments he offers his patients. But during his residency in otolaryngology, he found his way to sleep medicine. His friends weren’t surprised by that choice, he says, because he’s known for loving his sleep. His desire to help people sleep better is particularly relevant to those of us who live in the city that supposedly never sleeps. 

The most common sleep-related problem 

You guessed it: snoring.  

The main reason why a patient comes to Dr. Williams’ sleep clinic? “Their partner says they snore, and it’s keeping them awake.” 

According to the Sleep Foundation, snoring is caused by the rattling and vibration of tissues near the airway in the back of the throat. As a person inhales and exhales, the moving air causes these tissues to flutter and make the characteristic sound many of us know but don’t love.   

Some patients turn out to have sleep apnea—a potentially serious disorder in which breathing stops and starts during sleep. To receive a definitive diagnosis, a patient typically needs to undergo a sleep study, performed either at home or in the hospital. 

Treatments for sleep apnea 

There are both surgical and non-surgical ways to treat sleep apnea. 

Dr. Williams may perform surgery to remedy a deviated septum, nasal polyps, overly large tonsils or even a jaw that’s too narrow or too far back—all possible causes of apnea.  

Non-surgical treatments include: 

• Positional therapy: Instead of sleeping on your back, switch to your side. 
• CPAP (continuous positive airway pressure): A CPAP machine keeps your airways open while you sleep, reducing your risk of a heart attack or stroke. 
• Weight loss: If a patient suffers from obesity, Dr. Williams may prescribe one of the new GLP-1 inhibitors, along with a rigorous diet and exercise program. “Losing weight will improve sleep apnea,” he says, “often dramatically.” 

A “pacemaker” for apnea 

There’s another treatment that works well for people whose weight is within the normal range and who can’t tolerate the CPAP machine. It’s an upper airway stimulation device that’s implanted in the patient’s chest, where it monitors breathing during sleep.  

By delivering a mild electrical current to the hypoglossal nerve, which controls the muscles of the tongue, the device keeps the upper airway open and fosters normal breathing. Think of it as a pacemaker for apnea. 

“Sleep apnea isn’t fatal,” he says, “but it may shorten your lifespan. Left untreated, it may make you vulnerable to heart disease, stroke or dementia, especially in older age. If you’re young or in midlife, it may compromise your day-to-day performance. For these reasons, it’s extremely important to have your apnea treated.” 

Dr. Williams comes at the condition from multiple directions depending on its severity, along with the individual patient’s physical attributes and medical history.  

Oral and maxillofacial surgery 

Some of the procedures he uses to alleviate sleep apnea are applicable to a different set of problems: mainly those having to do with the jaw. 

From jaw structure abnormalities to fractures, cysts and tumors, he performs corrective surgery on jaw joints as well as reconstructive facial surgery in the event of trauma and injury. 

As an oral and maxillofacial surgeon, Dr. Williams treats the following: 

Wisdom teeth extractions, dental implants and biopsies of the mouth, tongue or throat are all in a day’s work for Dr. Williams, when he isn’t wearing his other hat—the one labeled ENT. That stands for ear, nose and throat. An ENT specialist is the same as an otolaryngologist, but it’s easier to remember! 

A bridge between medicine and dentistry 

First came his medical degree. Then came a residency in otolaryngology, a fellowship in sleep surgery and a doctor of medicine degree in dentistry. 

“I didn’t start out with the aim of doing this much training,” Dr. Williams says, “but I enjoy the variety. I also appreciate being a bridge between medicine and dentistry, and serving as an interdisciplinary resource. And the process is mutual. I learn a great deal from my colleagues as well as my patients.” 

If you suspect you have sleep apnea, your partner says you snore, or you’re a candidate for oral surgery, make an appointment with Dr. Williams here.