Surgery??

Has anyone had surgery in the hopes of "curing" OSA?

I'd like to hear what people know about ENT surgery.....

I was thinking about going to Mayo to be evaluated...

I went to a Sleep Apnea talk given by an ENT Doc for Doctors and Physicians Assistants. I was a guest. He seemed to indicate that the success rate is about 50% for the surgical procedures. He also talked about several newer procedures. Rods (I believe he said they were plastic) in the back part of the palet (stiffen the back part of the palet), Radio Frequency treatment (stiffen the back part of the palet), along with a couple of others, which escape me. He wasn't doing if I remember right, any of the newer procedures. He felt there wasn't enough experience with them yet.

I know that doesn't sound very encouraging, but I hope that helps. I would hope you would do some research, and not take the above for gospel truth. It is only what I have heard.

Duane

I'm just in the process of exploring my options, if there are any....

I have severe OSA and I need to get my tonsils out anyway because of recurrent infections and my uvula keeps swelling.

Thanks for the feedback.

Mayo Clinic in Rochester, MN should be a good place to go, wouldn't you think since patients from all over the World go there...

Sleeping With The Enemy wrote:Has anyone had surgery in the hopes of "curing" OSA?

Ok, straight off no one is advised to seek surgery until they've gone through the list of options: CPAP, APAP, dental device, etc. Further more, insurance is not likely to approve any major surgery until you've gone down that checklist. Sounds rediculous, but remember thier a business and don't want to pay for anything they don't deem necessary.

There are definitely options regarding treatment of OSA. When people post and refer to surgeries only having a 50% success rate, they are usually refereing to UPPP. The surgery is painful, can relapse, and overall a gamble.

The second surgery most people refer to is Septoplasty and turbinate reduction. This surgery is to correct nasal breathing problems. Many people find that CPAP isn't possible unless you can breath correctly, which those surgeries correct. I"ve had the surgeries last month, and so far, so good.

The next surgery, which is newer and confrontational, is the Pillar procedure (as mentioned by previous poster). They actually use a material, not Plastic, that has been used for surgical purposes for many years. Three small woven inserts are inserted into the soft palette. Over 3 months, the tissue around the inserts scars, leading to a hardening and rigidity of the palatte. This surgery is only effective if you have a palatal obstruction, which most people have a tongue and palatal obstruction. The surgery isn't usually covered by insurance, and costs around $1200.

Now, the BIG surgery that has some of the highest success rates is MMA/GA. MMA is MaxilloMandibular Advancement and GA is Genioglossus Tongue Advancement. These procedures are usually done together, and offer the highest rate of success. From what I've read and seen from studies/posts, the success rate is around 90% or higher. The procedure is MAJOR with a recovery period of 4-6 months, with 3-4 weeks having your jaw banded shut (not wired, as some will tell you).

There are several resources that describe the surgery in depth and have several people that had the surgery. Check out "NON-CPAP OPTIONS" on http://www.sleepnet.com under the sleep forums. Also, check out the Sleep Apnea forum on http://www.talkaboutsleep.com. BillinSeattle, WesternJoe, and others have had great success with the surgery. WesternJoe's Blog concerning the whole surgery ordeal is at: http://www.robotics.com/mma/

I hope you luck in your efforts, as I may be headed that way if my dental device doesn't give me the results I want/need.

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CPAPopedia Keywords Contained In This Post (Click For Definition): CPAP, APAP, Pillar Procedure

Well, I had a primary care doc who refused to get me into a sleep clinic to get a sleep study done, even though I told him I had gotten one done 6 years ago and already had been diagnosed with sleep apnea. I couldn't tolerate the nasal mask, but he didn't want to hear anything about it. Over a few months, along with going in for chronic infections I begged him to please get me into a sleep clinic. He wanted my tonsils out and wanted me to have the surgery. Well, I have medicare and this doc insisted that I go to this ENT. Well, I had sinus surgery when I was 15 and it didn't do any good. I didn't have a deviated septum. Come to find out after I went to an immunologist that I have EBV and that is why my tonsils keep swelling. Now he does not want my tonsils out, and since I started getting treatment for an immune problem possibly due to the virus/not sure-my tonsils haven't been swelling as often. I never did go to the ENT. I scheduled my own appointment with the only sleep doctor in town. He told me I was not a candidate for surgery, because of my weight /my neck being too big. I still need to find another primary care doc close to home before all my meds run out. Personally, I am gonna work with this cpap till I get the mask, and the hang of it I guess. I am going through a lot of trouble, but I believe that the full face mask will be my rock. From what I heard, the typical surgery sometimes only has a 30-50% success rate. I don't know anything about the other surgeries. I will be honest, I am afraid of surgery because of my weight and because of having post op infections. These surgeries, even a tonsillectomy is a very big deal in adults compared to children. If it becomes necessary, I will have my tonsils out. Not until I find a new doctor, and an ENT I pick that is also from my area. But, surgery is sometimes much more indicated in some patients than others. If your tonsils are a problem, and they keep getting infected or swollen, sometimes you just have to have them out. I don't know if this is part of the normal surgery for apnea. Just know that what works for one, doesn't work for another.
Good luck in your getting help for apnea or in your quest for info. Sorry for the long ramble.
Chelle

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CPAPopedia Keywords Contained In This Post (Click For Definition): medicare, CPAP

I'm in a similar situation as you right now, I did find huge relief in an apap but have been denied an apap by two different dr.s now. They want to do surgery so I began researching it looks to me like surgery at best is 50% and those that I have talked to said it was a temporary fix and a couple years down the road are back in the same boat. so for the time being I have opted not to have the surgery and am trying to get an apap one way or another we'll see if it works or not waiting for my letter to come in the mail. but another thing that is chasing me away is everyone one I've talked to said the surgery was torcher esp. the widening of the throat!!! so I'll keep trying but still don't understand why if an apap made me feel good why a cpap isn't? hang in there its a rough road I'm over a year into it now and offered a dr to cut my left leg off to put me back on an apap (figuring I could hobble and be able to function at the same time) his reply "your a prime candidate for surgery have the surgery and lose 40 pounds after you feel better and you'll be fine" I'm 5'11" 240 so overweight yes but come on!! I then said how about an apap and I'll lose 40# after I feel better? no I can't do that was the reply!!!

I've been using my Remstar Auto with C-flex for almost a year. My sleep study said 67.2 apnea episodes, so I have severe sleep apnea.

My CPAP works for me, but I don't really like the idea of sleeping with a snake the rest of my life, now if this thing was cordless, it would be another story.

Heidi

Battling Blazes, my I do feel bad for you. Why the heck would a doctor refuse the machine that worked for you. I guess it is just like they think they know all, and forget to include the needs of their patient. Can you get another doctor?
So many people on here love the APAP. I myself don't mind the C Flex, I am just more concerned about my mask and power outages. I would do whatever I could to find someone who would work with me. Good luck

SleepingWithTheEnemy-cool name if this is referring to sleep apnea. That is clever. If surgery would be a better option for you, check into all the different ones. Swordz, I think has another post somewhere on here about his dental device and other surgery. It was a very interesting read. I really hope you find something to work for you. Good luck to you also

Blessings
Chelle

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CPAPopedia Keywords Contained In This Post (Click For Definition): Power, APAP

Heidi, I agree with you. Live is better with cpap but I would greatly prefer to not to require its use.

chelle,
all I can tell ya is the dr.s tell me the apap is a tool for them to help prescribe the pressure setting needed. but for whatever reason can't seem to get it right!! Im still looking anybody know a open minded dr in ne ohio nw pennsylvania? erie cleveland youngstown anybody its been a rough road thats for sure

Chelle,

Yes, my name is because of my severe OSA. I feel that without my APAP I am sleeping with the enemy, OSA. It will kill you without treatment.

I think I may be too damn chicken to volunteer for any of these horrible sounding surgeries. I think if they told me 100% I'd do it.

I just had a Laproscopic Nissen Fundoloplication for GERD and am doing pretty good and also had a benign brain tumor removed in May of this year. Not sure if I'm up for another surgery yet, just thinking about options so that maybe someday I won't have to sleep with the snake.

Heidi

My you have had your share of surgery. I hope your future is bright and that your health is well. God bless you

Chelle

sapphireskye wrote:Swordz, I think has another post somewhere on here about his dental device and other surgery. It was a very interesting read.

Interesting? Well thanks! I'm actually getting publishing offers concerning my post.

If anyone is interested in my Dental Device route so far, here are my major posts:

Septoplasty and Turbinate Reduction Surgery

Recieved Dental Device Post

2nd Dental Device Update

It's been a timely endeavor, but I'm starting to see results and hopefully advancing over the next 3 wks will bring more good results.

Sleeping With The Enemy wrote:I think I may be too damn chicken to volunteer for any of these horrible sounding surgeries. I think if they told me 100% I'd do it.

Obviously no surgery is 100%, or we would all be going bust for some rich surgeons. BUT... MMA in combination with GA has a greater than 90% success rate. (Major surgery, wusses need not apply.)
I would highly reccomend anyone looking for anything close to a "cure" for OSA, and specifically MMA/GA surgery, check out sleepnet.com:

http://www.sleepnet.com/noncpap18/noncpap18.html

Several people have had MMA's lately and are keeping up well detailed and insightful posts there.

Battling Blazes...

You know that you can take a prescription for CPAP and send it to this site, CPAP.com......and say you want to BUY such and such APAP machine...and they will do it. With a prescription that just says CPAP. If you want to get your machine locally, yes, most places will require a script that specifically says APAP on it. But CPAP.com, rightly so, believes that an APAP machine is simply a TYPE of CPAP machine...since every APAP can also be used in CPAP mode. So if you are willing to pay out-of-pocket, you can have the machine of your dreams in a few days.

Your doctor really doesn't have to know exactly what machine you are using, now does he?

You can also contact the sister site, BILLMYINSURANCE.com, and see if they can work with your insurance. Same deal, I believe anyway. You just need a prescription that says CPAP on it and you can get an APAP machine. From what I've read on this board, the insurance code is the same for either type of machine, so it is no difference to your insurance company. They will only pay out one amount...they don't really care exactly what you GET for that amount.

Geez, I really and truly do not work for CPAP.com....but this is the second? third? post I've written today telling people to calm down and just order what they need from this internet site....or at least consider it if they are financially able...

Oh, and of course the other thing that probably needs to be said is that in effect your doctor is right. You can get perfectly good and adequate treatment from a CPAP machine and there is nothing wrong with straight CPAP. BUT, you stated you felt better with APAP, many people do....so I was responding to that statement.

Jan in colo.

I read WesternJoe's blog regarding his MMA/GA and it sounds like this guy is made of steel.

Now I've had my share of surgeries this year and I came through pretty darn well, even the nurses were suprised in both cases.

I just cringe when I read about this MMA/GA surgery.....sounds like hell!!

Heidi