Adenoidectomy and lingual tonsillectomy

Hello again,

Well, each post I've talked about how I'm fine with using the cpap, it's just that it isn't actually working and I'm still waking up from a whole lot of hypopneas. Turns out I'm not completely crazy because I finally saved up to go to the ENT for an endoscopy, and I have massive adenoid and lingual tonsil hypertrophy. The adenoids are the main reason that cpap isn't working, because they're completely blocking my nasal passages from the back. In order for cpap to work well, it needs to be able to have a decent flow of air. This is a lot of the reason that people complain about their cpap not working when they're sick and have a stuffy nose.

I know that surgery to correct cpap is controversial and in many cases is temporary, but based on all the studies I've read, most of the people that don't benefit are people that developed sleep apnea later in life due to aging, weight gain, and other factors that don't involve major hypertrophy of the tonsils. For people that developed sleep apnea in childhood from having kissing tonsils and a generally fucked lymphatic system, these surgeries are more effective.

Here is a summary of the typical success rates from medscape:

https://emedicine.medscape.com/article/1942134-overview

"Outcomes
Initially, the success rate of uvulopalatopharyngoplasty was reported to be less than 40%, with success defined as a reduction of respiratory disturbance index by 50% and an apnea-hypopnea index less than 10 or a respiratory disturbance index less than 20. [6] However, this low success rate was probably related to patient selection.

A staging system based on palate position, tonsil size, and body mass index was then established to aid with patient selection. [7, 8] Stage I patients had a palate size of 1 or 2 based on a modified Mallampati scale and tonsil size of 3 or 4 based on the Brodsky scoring system. These patients are the best candidates for surgery with a reported success rate of 80.6%. Stage II patients have a palate position and tonsil size of 3 or 4. Their success rate following uvulopalatopharyngoplasty was 37.9%.

Patients with a body mass index greater than 40 kg/m2 were classified as stage III and had a success rate of only 8.1%. These findings reiterate the need for proper patient selection and counseling prior to surgery."

Now, I know that the UPPP surgery has a lot of horror stories behind it, but I'm not getting the full work up that a lot of people had done in its early development. I'm only going to do the adenoidectomy and lingual tonsillectomy, and given that the standard tonsillectomy I had at 17 when I had kissing tonsils helped my breathing both asleep and awake A TON, I'm confident that this is a good choice for me. (Honestly, the adenoids are almost always just as massive as the tonsils, so the fact that my doctor back then didn't consider checking them out and removing them at the same time was a massive oversight.) I'm aware that I'll likely still need to use the cpap after the surgery, but I really don't mind. My main goal is to get the cpap to be more effective.

So for anyone reading this that's considering going through with surgery, based on the extensive research I've done over the past few weeks, don't do the base of tongue ablation or removal of the uvula or soft palate surgery (unless its the expansion pharyngoplasty, which has had decent results). Instead, stick with tonsil/adenoidectomy IF they are sufficiently large enough to need removal.

I'll be coming back after surgery to update on how my situation improves and everything. Though I'm 1000% positive about the adenoidectomy, I'm a little bit apprehensive about the lingual tonsillectomy since it's so close to the tongue. I'd love to hear about anyone's experience with it if they've had the procedure done.

Good luck with your surgery and I hope you have a speedy recovery.

Keep us posted on the results.

Fingers crossed for you.
Do keep us informed.

Hello, World? wrote: ↑

Mon Jan 15, 2018 10:08 pm

I'll be coming back after surgery to update on how my situation improves and everything.

Any update? My fingers are crossed in hopes of hearing excellent results.

Hello, World? wrote: ↑

Mon Jan 15, 2018 10:08 pm

I'll be coming back after surgery to update on how my situation improves and everything. Though I'm 1000% positive about the adenoidectomy, I'm a little bit apprehensive about the lingual tonsillectomy since it's so close to the tongue. I'd love to hear about anyone's experience with it if they've had the procedure done.

I had my adenoids removed when I had a tonsillectomy, when I was 8 or 9, because they were badly infected and swollen. More than doubled the surgery time, and added to the recovery, but totally knocked out my twice yearly bouts of tonsillitis. Hope all goes well for you. AND that you like jello and ice cream (ALL I could eat for days)..