Will a tonsillectomy render my APAP useless?

I have long heard the old story that if you have that sleep apnea surgery where the ENT surgeon takes our your tonsils, adenoids and other excess tissue, the surgery will essentially render your APAP useless past the minimum sustained pressure. Because the APAP technology somehow relies on that tissue being there to bounce air signals or whatever it is that APAPs do to determine if your airway is obstructed.

I know the last time I read that, it was a few years back. I think before the current crop of machines like the Resmed S9 APAP and the PR System One APAPs that came out that can detect (but not treat) central apneas in addition to obstructive apneas. I know the current generation of high end APAPs (Resmed/PR), are pretty sophisticated machines.

If I have my tonsils out, will it render my Resmed S9 APAP useless? I need to know. I saw an ENT surgeon recently, had a CAT scan of my neck today and will be seeing the ENT again later this week, surgery will probably be mentioned.

Keep in mind that if my OSA is not thoroughly under control, I become totally incapacitated....disabled basically. I cannot afford to play games with this and I really rely upon the autoPap and auto-Bipap technologies these days. Insurance is getting tighter and tighter about paying for attended sleep studies and is likely to get worse under obama care IMO. I cannot afford to be playing games. Im thinking my tonsils probably need to be cut out, but if that would affect my S9 APAP's ability to detect obstructions, then I'd be SOL after the surgery.

Thanks,

Eric

Not for a strict tonsillectomy. That might lower your pressure eventually. It is all the other stuff they take out that creates the problem.

Only if they take it into the or, and remove some parts from it. Jim

Are you thinking about UPPP surgery?
http://en.wikipedia.org/wiki/Uvulopalatopharyngoplasty

I don't think that it is the tonsillectomy or removal of the adenoids that has the potential to create a situation where cpap therapy is possibly more problematic.
I think it is the shaving and cutting of the other excess tissues.

If you're going to have your tonsils removed, you might as well go for widening your airway as much as possible. Check out this link about lateral pharyngoplasty, a method of suturing the tonsil incision:

http://www.sleepapneasurgery.com/pharyngoplasty.html

Beware that doctors don't use the term "pharyngoplasty" to mean the same thing, so be sure that your doctor's use of the term and your use of the term coincide.

THANK YOU! That is what I needed to know and I trust your opinion. I will run this by this ENT surgeon this week and make it very clear I do not want any "excess tissue" removed. If my S9 or PR System One APAP can no longer detect obstructions, I would be seriously SOL in the future.

On the other hand, if removing just my tonsils and adenoids and that significantly helps this recurring respiratory flareup stuff Ive been experiencing. AND also maybe helps my OSA some, then that would be a win/win scenario for me. Just as long as it does not effect my APAP detecting ability.

Eric

Pugsy wrote:Are you thinking about UPPP surgery?
http://en.wikipedia.org/wiki/Uvulopalatopharyngoplasty

I don't think that it is the tonsillectomy or removal of the adenoids that has the potential to create a situation where cpap therapy is possibly more problematic.
I think it is the shaving and cutting of the other excess tissues.

No, I want nothing to do with that UPPP surgery. Ive read nothing but bad stuff about it. People have that and they complain about getting bits of food and drink stuck in the back of their throat and their APAPs no longer work well. Plus, UPPP surgery has a poor efficacy reputation at helping alleviate OSA.

Eric

Pugsy wrote:Are you thinking about UPPP surgery?
http://en.wikipedia.org/wiki/Uvulopalatopharyngoplasty

Uh, I like my APAP and all Im interested in is stopping these ear, nose and throat infection flareups. Thats all I want from the surgery. Im thinking "less is more" in my case.

Eric

SleepingUgly wrote:If you're going to have your tonsils removed, you might as well go for widening your airway as much as possible. Check out this link about lateral pharyngoplasty, a method of suturing the tonsil incision:

http://www.sleepapneasurgery.com/pharyngoplasty.html

Beware that doctors don't use the term "pharyngoplasty" to mean the same thing, so be sure that your doctor's use of the term and your use of the term coincide.

BlackSpinner wrote:Not for a strict tonsillectomy. That might lower your pressure eventually. It is all the other stuff they take out that creates the problem.

Thanks.

Eric

I am going to sternly ask this ENT surgeon this same question, btw. And also it is all being run by my sleep medicine doctor. No UPPP, but strict tonsillectomy/andenoid removal probably OK.

Eric

I read a UPPP removes the following:



The uvula (see uvulotomy)
The soft palate.
The tonsils
The adenoids, and
The pharynx.


Thats a lot of stuff. This ENT surgeon also does sleep apnea surgery. All Im thinking I need is a tonsillectomy and adenoid removal...the stuff that affects the infections. Its this other stuff that gets removed that causes problems with APAPs and auto-Bipaps?

Suddenly Worn Out wrote:Its this other stuff that gets removed that causes problems with APAPs and auto-Bipaps?

That's my understanding.

Besides...from what people here who have had the surgery say...besides either it didn't help or only offered short term resolution of the sleep apnea or they can't get cpap adjusted now...they all say it hurts like a SOB for quite a while.

Suddenly Worn Out wrote:Uh, I like my APAP and all Im interested in is stopping these ear, nose and throat infection flareups. Thats all I want from the surgery. Im thinking "less is more" in my case.

Eric

SleepingUgly wrote:If you're going to have your tonsils removed, you might as well go for widening your airway as much as possible. Check out this link about lateral pharyngoplasty, a method of suturing the tonsil incision:

http://www.sleepapneasurgery.com/pharyngoplasty.html

Beware that doctors don't use the term "pharyngoplasty" to mean the same thing, so be sure that your doctor's use of the term and your use of the term coincide.

Why wouldn't you want to stitch the tonsillectomy closed in such a way that it widens your airway as much as possible? It may not cure your OSA (unless your tonsils are huge) but a wider airway is better.

Several doctors in the last few years have mentioned to me I have "enlarged tissue in the back of my throat," mentioned in the context of my OSA. It was not until last week when I went to see this dental sleep med guy that I was told I have an actual tonsil infection. Following onto the heels of all the respiratory infections Ive had in the last year or more and prior to that as well, Im honestly more focused right now on two things:

1) getting rid of any tissue that is causing blockages that is causing bacteria to build up and contributing to these recurrent ear, nose and throat infections

2) getting more comfortable mask and headgear that puts less pressure on my sinuses

I will just say it. I dont trust some of these doctors. They make their money doing certain things. An ENT makes their money by cutting on people. The more the cutting, the more money they make. All I want is the infection causing tissues removed and i want everything else left alone. I dont want to take ANY CHANCES on disturbing my close relationship (and successful one too) with my APAPs. Hence my conservative attitude and approach here.

As Pugsy mentioned, UPPP and most other sleep apnea surgeries dont have that good of a reputation. I dont have much if any faith in them. I do want these recurrent ear, nose and throat infections gone, though.

Eric

SleepingUgly wrote:[quote="Suddenly Worn Out"

Why wouldn't you want to stitch the tonsillectomy closed in such a way that it widens your airway as much as possible? It may not cure your OSA (unless your tonsils are huge) but a wider airway is better.

Hi,

I originally read your post wrong thinking you were wanting the surgery mainly for OSA. I note that it's for infections is that right? Is this a common problem?

It's really something you need to speak to your physician about. It may really help with your sleep apnea - it might not. One would assume that you might get away with a lower pressure if you get it done. Or it could be the other way. It all depends.

Are you able to see a sleep physician?