Throat Surgery??
Question:
I’ve been on CPAP for over a year. My Doctor told me that if I had my tonsils removed and my throat opened up via laser surgery that I had a 80% chance of going off CPAP. I’d like to know if anyone here has had that done and did you get off the CPAP machine. I also wondered what I should expect if I decided to do that. Thanks for your advise Bob
Response:
I had a UPPP with tonsillectomy and didn’t need CPAP for about six months. Then I went on BiPAP due to headaches from CPAP. This is typical for most people. Note that success for the surgery is a 50% reduction in apneas. If you have severe apnea, that might get you down to the moderate level. You’ll still need a CPAP. Big Al db-g…@bignospamfoot.com Remove nospam to reply via email – Hide quoted text — Show quoted text -Bob wrote: > I’ve been on CPAP for over a year. My Doctor told me that if I had my > tonsils removed and my throat opened up via laser surgery that I had a 80% > chance of going off CPAP. I’d like to know if anyone here has had that done > and did you get off the CPAP machine. I also wondered what I should expect > if I decided to do that. > Thanks for your advise > Bob
Response:
On Mon, 3 Jan 2000 20:20:33 -0500, "Bob" <bobd…@cybertours.com> wrote: >I’ve been on CPAP for over a year. My Doctor told me that if I had my >tonsils removed and my throat opened up via laser surgery that I had a 80% >chance of going off CPAP.
Remember that he has a 100% chance of getting his fee if you follow his advice, and a 0% chance if you do not.
Response:
In article <38714a7…@news.cybertours.com>, "Bob" <bobd…@cybertours.com> wrote: > I’ve been on CPAP for over a year. My Doctor told me that if I had my > tonsils removed and my throat opened up via laser surgery that I had a 80% > chance of going off CPAP. I’d like to know if anyone here has had that done > and did you get off the CPAP machine. I also wondered what I should expect > if I decided to do that. > Thanks for your advise > Bob
What is your doctor basing his analysis of this "80% chance" on? Did he perform a more thorough examination for your particular point of obstruction (like a cephalogram and a Mueller Manuever?)?. Or was it just a cursery examination of your throat, i.e. say "ahhh". Sounds to me like he’s just guessing (like what alot of these ENT docs simply will do). The more I learn about OSA, the more I’m convinced that alot of this OSA obstruction involves the retrolingual level (i.e. base of the tongue area). And tonsillectomy or the "opening up of the throat via laser surgery" (which sounds like a LAUP or maybe a UPPP) doesn’t really address this area….They might help your snoring a little, but may most likely not significantly improve your OSA. I personally wouldn’t go thru with it unless he’s done a far more extensive and thorough examination of your point of obstruction. Sent via Deja.com http://www.deja.com/ Before you buy.
Response:
In article <84suqk$3f…@nnrp1.deja.com>, jerryc…@my-deja.com says… – Hide quoted text — Show quoted text -> In article <38714a7…@news.cybertours.com>, > "Bob" <bobd…@cybertours.com> wrote: > > I’ve been on CPAP for over a year. My Doctor told me that if I had my > > tonsils removed and my throat opened up via laser surgery that I had > a 80% > > chance of going off CPAP. I’d like to know if anyone here has had > that done > > and did you get off the CPAP machine. I also wondered what I should > expect > > if I decided to do that. > > Thanks for your advise > > Bob > What is your doctor basing his analysis of this "80% chance" on? Did he > perform a more thorough examination for your particular point of > obstruction (like a cephalogram and a Mueller Manuever?)?. Or was it > just a cursery examination of your throat, i.e. say "ahhh". Sounds to > me like he’s just guessing (like what alot of these ENT docs simply > will do). The more I learn about OSA, the more I’m convinced that alot > of this OSA obstruction involves the retrolingual level (i.e. base of > the tongue area). And tonsillectomy or the "opening up of the throat > via laser surgery" (which sounds like a LAUP or maybe a UPPP) doesn’t > really address this area….They might help your snoring a little, but > may most likely not significantly improve your OSA. I personally > wouldn’t go thru with it unless he’s done a far more extensive and > thorough examination of your point of obstruction. > Sent via Deja.com http://www.deja.com/ > Before you buy.
My doctor is recommending a combo – UPPP, tonsillectomy, and a newer procedure to pull the base of the tongue forward (using a single pin in the jaw – much less messy than previous procedures involving the tongue). He says the combination is the key to the potential success. The UPPP and tonsils usually help with the noise, but the base of the tongue can still hit the back of the throat. Likewise, moving the tongue by itself still allows the fleshy tissue of the uvula and around the tonsils to sag and block the airway. My doctor has used both a visual exam and two scopings, and factored in the fact that although I have severe apnea now, my CPAP setting is only a 6, leading him to believe that with a the surgical help, my airway should be able to stay open. I feel that he’s been thorough, but I’m trying to keep my expectations reasonable…
Response:
Bob, I’m not a doctor, and I’m not trying to second guess yours… However, I had my tonsils and adenoids removed and a small nick to straighten out my uvula as a pre-teen (12 or 13). Here I am at 35 on BiPAP. If you have doubts, please, please check with a second specialist who deals with apnea on a regular basis. What does the doctor mean by "open up your throat"- laser ablation or something else?
Response:
In article <MPG.12dc4b3e3abdb418989…@news.prodigy.net>, Ho…@springfield.com (Homer J Simpson) wrote: – Hide quoted text — Show quoted text -> In article <84suqk$3f…@nnrp1.deja.com>, jerryc…@my-deja.com says… > > In article <38714a7…@news.cybertours.com>, > > "Bob" <bobd…@cybertours.com> wrote: > > > I’ve been on CPAP for over a year. My Doctor told me that if I had my > > > tonsils removed and my throat opened up via laser surgery that I had > > a 80% > > > chance of going off CPAP. I’d like to know if anyone here has had > > that done > > > and did you get off the CPAP machine. I also wondered what I should > > expect > > > if I decided to do that. > > > Thanks for your advise > > > Bob > > What is your doctor basing his analysis of this "80% chance" on? Did he > > perform a more thorough examination for your particular point of > > obstruction (like a cephalogram and a Mueller Manuever?)?. Or was it > > just a cursery examination of your throat, i.e. say "ahhh". Sounds to > > me like he’s just guessing (like what alot of these ENT docs simply > > will do). The more I learn about OSA, the more I’m convinced that alot > > of this OSA obstruction involves the retrolingual level (i.e. base of > > the tongue area). And tonsillectomy or the "opening up of the throat > > via laser surgery" (which sounds like a LAUP or maybe a UPPP) doesn’t > > really address this area….They might help your snoring a little, but > > may most likely not significantly improve your OSA. I personally > > wouldn’t go thru with it unless he’s done a far more extensive and > > thorough examination of your point of obstruction. > > Sent via Deja.com http://www.deja.com/ > > Before you buy. > My doctor is recommending a combo – UPPP, tonsillectomy, and a newer > procedure to pull the base of the tongue forward (using a single pin in > the jaw – much less messy than previous procedures involving the tongue). > He says the combination is the key to the potential success. The UPPP > and tonsils usually help with the noise, but the base of the tongue can > still hit the back of the throat. Likewise, moving the tongue by itself > still allows the fleshy tissue of the uvula and around the tonsils to sag > and block the airway. > My doctor has used both a visual exam and two scopings, and factored in > the fact that although I have severe apnea now, my CPAP setting is only a > 6, leading him to believe that with a the surgical help, my airway should > be able to stay open. I feel that he’s been thorough, but I’m trying to > keep my expectations reasonable…
Yeah…That’s what I’m beginning to hear more and more, i.e. that both the retropalatal and retrolingual areas need to be addressed properly. (I’m just a little concerned about the tonsillectomy, though. Not to say that this isn’t right for your situation, but I’m beginning to hear that the tonsils (the tissues that sort of surround the inner sides of the throat) gives support for the tongue and often keeps the tongue from falling completely back into the throat. If only the UPPP and tonsillectomy were performed, there’s a chance the tongue can fall further back than previously and thereby worsen the obstruction at the base of the tongue. Hopefully the tongue advancement procedure you mentioned (which sounds to me like a gennioglossus advancement) would more than compensate for the slack… (with fingers crossed)…Surgery for OSA is always a gamble. And most of the time it’s irreversible (save a trach, which is reversible). If it’s at all possible, I’d like to know what your docs feedback will be on this point just mentioned. If you can present this concern to him and maybe get back to us on what he says? Sent via Deja.com http://www.deja.com/ Before you buy.
Response:
In article <84vc5a$nd…@nnrp1.deja.com>, jerryc…@my-deja.com says… – Hide quoted text — Show quoted text -> In article <MPG.12dc4b3e3abdb418989…@news.prodigy.net>, > Ho…@springfield.com (Homer J Simpson) wrote: > > In article <84suqk$3f…@nnrp1.deja.com>, jerryc…@my-deja.com > says… > > > In article <38714a7…@news.cybertours.com>, > > > "Bob" <bobd…@cybertours.com> wrote: > > > > I’ve been on CPAP for over a year. My Doctor told me that if I > had my > > > > tonsils removed and my throat opened up via laser surgery that I > had > > > a 80% > > > > chance of going off CPAP. I’d like to know if anyone here has had > > > that done > > > > and did you get off the CPAP machine. I also wondered what I > should > > > expect > > > > if I decided to do that. > > > > Thanks for your advise > > > > Bob > > > What is your doctor basing his analysis of this "80% chance" on? > Did he > > > perform a more thorough examination for your particular point of > > > obstruction (like a cephalogram and a Mueller Manuever?)?. Or was it > > > just a cursery examination of your throat, i.e. say "ahhh". Sounds > to > > > me like he’s just guessing (like what alot of these ENT docs simply > > > will do). The more I learn about OSA, the more I’m convinced that > alot > > > of this OSA obstruction involves the retrolingual level (i.e. base > of > > > the tongue area). And tonsillectomy or the "opening up of the throat > > > via laser surgery" (which sounds like a LAUP or maybe a UPPP) > doesn’t > > > really address this area….They might help your snoring a little, > but > > > may most likely not significantly improve your OSA. I personally > > > wouldn’t go thru with it unless he’s done a far more extensive and > > > thorough examination of your point of obstruction. > > > Sent via Deja.com http://www.deja.com/ > > > Before you buy. > > My doctor is recommending a combo – UPPP, tonsillectomy, and a newer > > procedure to pull the base of the tongue forward (using a single pin
The tongue-related procedure isnt’t the ‘traditional’ genioglossus advancement, which I heard used multiple bolts. This procedure is newer, uses a single pin and a couple of stitches, and is supposed to be reversible (I guess they’d just remove the stitches and yank the pin). There’s supposed to be no special recovery procedures, other than the regular precautions related to the tonsillectomy.
Response:
On Wed, 5 Jan 2000 08:27:42 -0600, in alt.support.sleep-disorder Ho…@springfield.com (Homer J Simpson) wrote: >The tongue-related procedure isnt’t the ‘traditional’ genioglossus >advancement, which I heard used multiple bolts. This procedure is newer, >uses a single pin and a couple of stitches, and is supposed to be >reversible (I guess they’d just remove the stitches and yank the pin). >There’s supposed to be no special recovery procedures, other than the >regular precautions related to the tonsillectomy.
The technique is known as "Repose" and involves a permanent (?) suture attached to a fixing into the lower jaw bone. After the initial publicity some months ago, virtually nothing has been posted on this newsgroup (or other sleep apnea fora) about this technique. Influence Medical, who market the Repose technique, are at: http://www.influencemedical.com/ — Tony Polson, North Yorkshire, UK
Response:
In article <MPG.12dd10d918cb0120989…@news.prodigy.net>, Ho…@springfield.com (Homer J Simpson) wrote: – Hide quoted text — Show quoted text -> In article <84vc5a$nd…@nnrp1.deja.com>, jerryc…@my-deja.com says… > > In article <MPG.12dc4b3e3abdb418989…@news.prodigy.net>, > > Ho…@springfield.com (Homer J Simpson) wrote: > > > In article <84suqk$3f…@nnrp1.deja.com>, jerryc…@my-deja.com > > says… > > > > In article <38714a7…@news.cybertours.com>, > > > > "Bob" <bobd…@cybertours.com> wrote: > > > > > I’ve been on CPAP for over a year. My Doctor told me that if I > > had my > > > > > tonsils removed and my throat opened up via laser surgery that I > > had > > > > a 80% > > > > > chance of going off CPAP. I’d like to know if anyone here has had > > > > that done > > > > > and did you get off the CPAP machine. I also wondered what I > > should > > > > expect > > > > > if I decided to do that. > > > > > Thanks for your advise > > > > > Bob > > > > What is your doctor basing his analysis of this "80% chance" on? > > Did he > > > > perform a more thorough examination for your particular point of > > > > obstruction (like a cephalogram and a Mueller Manuever?)?. Or was it > > > > just a cursery examination of your throat, i.e. say "ahhh". Sounds > > to > > > > me like he’s just guessing (like what alot of these ENT docs simply > > > > will do). The more I learn about OSA, the more I’m convinced that > > alot > > > > of this OSA obstruction involves the retrolingual level (i.e. base > > of > > > > the tongue area). And tonsillectomy or the "opening up of the throat > > > > via laser surgery" (which sounds like a LAUP or maybe a UPPP) > > doesn’t > > > > really address this area….They might help your snoring a little, > > but > > > > may most likely not significantly improve your OSA. I personally > > > > wouldn’t go thru with it unless he’s done a far more extensive and > > > > thorough examination of your point of obstruction. > > > > Sent via Deja.com http://www.deja.com/ > > > > Before you buy. > > > My doctor is recommending a combo – UPPP, tonsillectomy, and a newer > > > procedure to pull the base of the tongue forward (using a single pin > The tongue-related procedure isnt’t the ‘traditional’ genioglossus > advancement, which I heard used multiple bolts. This procedure is newer, > uses a single pin and a couple of stitches, and is supposed to be > reversible (I guess they’d just remove the stitches and yank the pin). > There’s supposed to be no special recovery procedures, other than the > regular precautions related to the tonsillectomy.
You forgot to mention the most important description of this surgery ;-> i.e. A thread (which is threaded at the base of the tongue) pulls the tongue forward, right? What you’re talking about is the Repose. It’s fairly new. I haven’t heard too much feedback from anyone who’s had this yet. Sent via Deja.com http://www.deja.com/ Before you buy.
Response:
<<But you can do what you like. I would guess that the two docs at Stanford would be best, but do a laser job, not the cutting.>> Thank you for your information – I’m located in San Jose. I’m trying to figure out who do I need to see first. My family doctor or pick any "Ear-Nose-Throat" doctor. I want to know that my choice is a good one. Karen
Response:
If your family Doc can get you a referral to a sleep specialist then the Primary, if not then the ENT, who should have more practical experience on the causes and treatment of sleep disorders (or at least sleep apnea).
Response:
Gary, I’m sure the results vary based on allergies and sinus condition. I had been a mouth breather with chronic sinusitus and allergic rhinitis for 20 years before being diagnosed with sleep apnea. My study revealed an average of 106 apneas per hour over a 6 hour period. They should me that every time I would make it to rem, boom I stopped in my tracks. My ENT conned me into the "Roto-Rooter" combination of sinus and uvula at the same time. I don’t think he even read my history (HMO’s ya gotta love ‘em) or he was just after the extra income. My recovery, allowing me to experience real pain and drink 6 gr. codiene in suspension (practically needed it prn!) till I was too stupid to care, was quite an excruciating experience. When the packing and gel-pack were removed, I could not believe the air-flow! However, within the next allergy season, I had returned to 50% of my previous state. CPAP was started, but because of excessive dryness in my throat (due to scarring) I could not tolerate it. So now I’m back to same-same with all the byproducts and then some. If you are considering this combo make sure that allergies aren’t going to be a recovery factor. Bill
Response:
Karen, The reason most of us were sleeping with our mouths open was because we were not getting enough oxygen, once that problem is solved, sleeping with your mouth closed becomes easier for some (like me), or you retrain yourself as some have done, or wear a chin strap as some have done, or you use a full face mask that covers both the nose and mouth as some have done. CPAP is worth the little extra effort to make sure it is working as intended, if apnea is what the problem turns out to be. Like any other illness, time is needed to heal the damage, but a majority of us have had good results with a little effort on our part. To find a center near you, you can check out the ASDA accredited sleep labs page at: http://www.asda.org/centers.htm – Hide quoted text — Show quoted text -MKSAM wrote: > I personally breathe thru my mouth and don’t see how using the CPAP could work > at all. I’m dying to get my problem fixed. My husband can’t sleep anymore > either. > I want to know where in Northern California I can go for help!!!! > Karen
Response:
Where are you located? Northern California is several hundred miles. So you are saying you don’t want to use the cpap since you would have to breathe through your nose, unless the full face mask would work? I see the subject line now, well zapping the throat is nice and pretty, according to the docs at Stanford, only a couple of problems can happen, 1) your apnea is also caused by your tongue and doctors are unable to be precise on the exact obstruction and the other is that the tissue tends to grow back. But you can do what you like. I would guess that the two docs at Stanford would be best, but do a laser job, not the cutting. – Hide quoted text — Show quoted text -MKSAM wrote: > I personally breathe thru my mouth and don’t see how using the CPAP could work > at all. I’m dying to get my problem fixed. My husband can’t sleep anymore > either. > I want to know where in Northern California I can go for help!!!! > Karen
Response:
> MKSAM wrote: > > I personally breathe thru my mouth and don’t see how using the CPAP could work > > at all. I’m dying to get my problem fixed. My husband can’t sleep anymore > > either. > > I want to know where in Northern California I can go for help!!!! > > Karen
I was a mouth breather until I got my CPAP, a chin strap, and Nasonex nasal spray. I now sleep without the chin strap and still keep my mouth shut. Gary (keeping my mouth shut – my mom is STILL shocked that it is possible) Rimar
Response:
<<I’ll let someone else help with the Norhtern California question. But an approximate location would help others locate centers in your area.>> I’m looking for help in Santa Clara County. Thanks for the support. Karen
Response:
On 13 Jan 2000 05:07:02 GMT, mk…@aol.com (MKSAM) wrote: > | I personally breathe thru my mouth and don’t see how using the CPAP could work > | at all. I’m dying to get my problem fixed. My husband can’t sleep anymore > | either. > | I want to know where in Northern California I can go for help!!!! > | Karen
Karen, lots of us breathe through our mouths but can use CPAP. I am a lifelong mouth breather but can manage to breathe through my nose if forced, heh, heh. I have actually trained myself to nose breathe while using CPAP. Some people use chin straps to keep their mouths closed. I also had a septoplasty to make nasal breathing easier, but this was because I also had nasal polyps and my nose closed up completely. I had to have the septoplasty in order to reach the nasal polyps to remove them. It was not a severe operation. There are also "full face" masks that cover the nose and mouth that many find quite efficient. People seem to think that the Mirage full face mask is best so far. —————————————————- "Trudy is Beauth, Beauth, Trudy"
