surgical approach to OSA

I would like to hear from some folks who have had surgical/laser treatment for structural causes of sleep apnea. I have heard of procedures that shave tissue in the tongue/throat area to make a wider opening. Is this still done today? How do they determine if you would benefit from this type of procedure? I wonder how they know where the obstruction is? I keep hearing about CPAP keeping nasal passages open but what if the tongue is what is getting in the way? Can you help me understand this?

It works to some degree for a limited time. The pain and agony post surgery has been compared to several weeks of childbirth. I wouldn't consider it unless you are into pain. CPAP is painless and much cheaper. It just takes getting used to. If you are obese cpap may help you loose the weight . Don't consider surgery without first trying CPAP. In my case its an easy choice. I can't breathe without it!

Hi barbyann,

Please see this post by rested gal. It gives you a lot of links for surgeries.

viewtopic.php?t=2836&start=0&postdays=0 ... ht=surgery

She's the best, isn't she?!!

My head is spinning from all the information presented. Believe me, I will read every word.

The biggest thing to remember is that surgery does not work for everyone, matter of fact it has a pretty poor success rate. Besides the pain, you also have to worry about how well cpap will work AFTER surgery. I have heard from a few folks that have had the surgeries done, and now they are on CPAP and having a lot of problems getting it to work for them...

Meanwhile CPAP is 100% effective for OSA...

Personally I like those odds better...

I had the turbinate reduction somnoplasty and it didn't help my nose. It didn't hurt, but didn't help.

I have spoken to a surgeon about throat surgery. It would require removal of my tonsils, adenoids, and repositioning of my tongue. He says it is a very painful two recovery. The average person loses 10 lbs. due to an inability to eat because of the pain.

On the other hand, I spoke to a woman in his waiting room that just had it done a few weeks prior. She had very little pain and greatly improved sleep apnea to the point of not having to use a CPAP anymore.

My doctors said, someone with severe sleep apnea, as I do, would require several different surgeries as many different mechanisms are involved in causing severe SA. At best they said the success rate would be around 45%, so near even odds to spend all the money, go through all the pain and recovery, and 50/50 to have it help.

This made xPap look like a lot better option than it did at first, to me anyway.


Ron

A lot of people look at surgery as an easy out, since they can't stand the thought of the mask and the machine, but the truth is, so far there is no surgery that is long lasting. They may help for a year or two and then you will have to go back on CPAP. The side effects of the removal of the uvula, soft palate and tonsils is aspiration of fluids, gagging on anything dry. These are long term. The surgeries are also only recommended for those with mild to moderate OSA. The only possible surgery that MIGHT be long-lived is the Pillar implant where pillars are implanted in the soft palate to stiffen it. It is done in office and does seem to be rather successful, but again only in mild cases, and is actually only correcting one cause of OSA.

Research has shown that use of a CPAP will help tighten the soft palate because it is allowed to return to its normal firmness from the cessation of snoring which vibrates it and causes it to sag. I mentioned this to my ENT who is pushing me to have surgery and she admitted that was true. I have an appointment next week to have a 6 month recheck after being on CPAP. I think she will still probably push the surgery because of my deviated septum, but I don't have swollen tonsils and I am thinking my uvula size might also be affected beneficially by the CPAP therapy. And besides I don't want to lose 10 pounds THAT bad to endure 2 weeks or more of that kind of pain.