OSA OPERATION ? LATEST ENT SURGERY TO CURE IT!

[DyingOnMyFeet]

if I am wrong the worst that can happen is my ENT surgeon lied to me and I wasted $5600.00

Wrong...the worst that can happen to you is all that missing tissue in the back of the throat that can't ever be put back.
Can't pronounce words like you used to (the uvula thing is kinda important for speech)
Can't drink liquids without them shooting out your nose
Google complications from the UPPP procedure...the list is long.
The pain....no one has ever said the UPPP wasn't anything but horribly painful
If it fails..almost every UPPP patient here at the forum has trouble finding optimal pressure...and yes...we have UPPP patients here
Have no idea what the tongue channeling thing does but it sounds scarier than hell.

Only thing I might do or consider doing would be the tonsillectomy...first and all by itself and only if the tonsils were chronically enlarged.

What was your AHI pre cpap?
What constitutes "success" from the doctor's point of view? Remember his idea of success may not be the same as yours.
Does he have post op follow up sleep studies to confirm whatever his "success" is?

Hi Pugsy pleased to meet you here is the info on my preposed operation and it's sucesss rate for OSA - with love Peter from Australia

Modified uvulopalatopharyngoplasty and coblation channeling of the tongue for obstructive sleep apnea: a multi-centre Australian trial.
MacKay SG1, Carney AS, Woods C, Antic N, McEvoy RD, Chia M, Sands T, Jones A, Hobson J, Robinson S.
Author information
Abstract
STUDY OBJECTIVES:
To investigate the surgical outcomes and efficacy of modified uvulopalatopharyngoplasty (mod UPPP) and Coblation channelling of the tongue (CCT) as a treatment for obstructive sleep apnea (OSA).
METHODS:
Adult patients with simple snoring or obstructive sleep apnea were treated with combined modified UPPP, bilateral tonsillectomy, and CCT (N = 48). Full polysomnography was performed preoperatively and 3 months postoperatively. Postoperative clinical assessment, sleep questionnaires, and patient demographics including body mass index were compared to preoperative data. All polysomnograms were re-scored to AASM recommended criteria by 2 sleep professionals.
RESULTS:
The preoperative AHI (median and interquartile range) of 23.1 (10.4 to 36.6) was lowered to a postoperative AHI of 5.6 (1.9 to 10.4) (p < 0.05). The Epworth Sleepiness Scale score fell from 10.5 (5.5 to 13.5) to 5.0 (3.09 to 9.5) (p < 0.05). Morbidity of the surgery was low, with no long-term complications recorded.
CONCLUSIONS:
Modified UPPP combined with CCT is a highly efficacious intervention for OSA with minimal morbidity. It should be considered for individuals who fail or are intolerant of CPAP or other medical devices.
How many of these "make a boat payment" procedures has he done? Confirmation of success? How?
Is it a 50% reduction in apnea events? Would be great if your AHI pre cpap was 10....and totally suck if it was 50 like mine was.

Sounds like some sort of tongue ablation procedure. That's been around in some form or other for a long time without any great success rate.

You can put the money back in your bank account if it fails.....you can't do a damn thing about the permanently missing tissue in your mouth and throat. Hell, even a trach is reversible.

[archangle]

RUN AWAY!!!

KEEP RUNNING!!!!



Seriously, Google the horror stories on UPPP.

It's a great idea. One of these days, they'll figure out a good surgical/implant way to fix apnea.

Until then, let some other guinea pigs suffer the nasty side effects and poor treatment. Remember, you can can always stop CPAP and do surgery when they perfect the technique. Or even when they prove the current technique he's proposing works well.

Especially be careful that the surgeon's definition isn't the same as your definition. They call it success if you still need CPAP, but have a lower AHI.

[Pugsy]

I googled it. It's an RF tongue ablation (for some reason it seems to be called "coblation" -- the only difference being the use of RF). It uses a probe that's inserted deep into the tongue to kill muscle tissue inside the tongue, creating "channels" around the probe while leaving the surface (relatively) untouched. The tongue is then supposed to heal around the channels that have been burned into it, causing it to shrink.

From the studies I found, it seems to be a procedure popular in Australia and perhaps developed there.

Ouch...let's make the UPPP even more drastic and painful.

Since Peter is in Australia I guess maybe his doc is someone who maybe pioneered this type of surgery.
And yes, long term success rates have been poor or we wouldn't have so many forum members coming here and saying "I had the UPPP done 5 years ago but my OSA has returned".

You know I can understand a young person's need or desire for a "cpapless" life but the odds are they buy themselves a few years if they are lucky and have initial success but long term it can potentially actually be worse and make using cpap more of a challenge in terms of pressure needs and feeling better. Not to mention what happens if they are part of the unlucky % who don't have success initially and that's not even factoring in whatever definition "success" might be.
Success for a surgeon might be a 50% reduction in AHI and that may not be enough....and let's not forget that there's so much more to this cpap therapy than just an AHI number anyway.

I would be more likely to have one of those implants to stimulate the hypoglossal nerve than I would any type of destructive tissue surgery....at least the implant can be remove.

But maybe as a younger person the risk is worth it. Not my place to judge a person's perceived quality of life and if "cpapless" would GREATLY increase their perception and they think the reward is worth the risk......

Though I would question what constitutes "success" and how is it measured.
Edit: I see Peter has listed as study and how they measure things...hmmm...short term only.

Peter...question for you...what is/was your AHI without CPAP use? What was it on your diagnostic sleep study?
What is your AHI now on CPAP?

[DyingOnMyFeet]

I googled it. It's an RF tongue ablation (for some reason it seems to be called "coblation" -- the only difference being the use of RF). It uses a probe that's inserted deep into the tongue to kill muscle tissue inside the tongue, creating "channels" around the probe while leaving the surface (relatively) untouched. The tongue is then supposed to heal around the channels that have been burned into it, causing it to shrink.

From the studies I found, it seems to be a procedure popular in Australia and perhaps developed there.

Ouch...let's make the UPPP even more drastic and painful.

Since Peter is in Australia I guess maybe his doc is someone who maybe pioneered this type of surgery.
And yes, long term success rates have been poor or we wouldn't have so many forum members coming here and saying "I had the UPPP done 5 years ago but my OSA has returned".

You know I can understand a young person's need or desire for a "cpapless" life but the odds are they buy themselves a few years if they are lucky and have initial success but long term it can potentially actually be worse and make using cpap more of a challenge in terms of pressure needs and feeling better. Not to mention what happens if they are part of the unlucky % who don't have success initially and that's not even factoring in whatever definition "success" might be.
Success for a surgeon might be a 50% reduction in AHI and that may not be enough....and let's not forget that there's so much more to this cpap therapy than just an AHI number anyway.

I would be more likely to have one of those implants to stimulate the hypoglossal nerve than I would any type of destructive tissue surgery....at least the implant can be remove.

But maybe as a younger person the risk is worth it. Not my place to judge a person's perceived quality of life and if "cpapless" would GREATLY increase their perception and they think the reward is worth the risk......

Though I would question what constitutes "success" and how is it measured.
Edit: I see Peter has listed as study and how they measure things...hmmm...short term only.

Peter...question for you...what is/was your AHI without CPAP use? What was it on your diagnostic sleep study?
What is your AHI now on CPAP?

Hi Pugsy - I can't remember my AHI before cpap use and I don't know what my AHI is now on cpap as my machine does not store data I guess I could always ring the sleep centre and get my AHI stats - with love Peter from Australia P.S. My ENT surgeon said to me his meaning of sucess of operation was to be free of cpap for good he has been in the business for 25 years.

[library lady]

My response is: YUCK! I would not consider this surgery if you paid me! I read something somewhere, a person was telling about the aftermath of his UPPP and when he was eating spaghetti a spaghetti string came out of his nose instead of going down his throat. Not a pretty picture.

I won't go into all the reasons why you want approach this with caution as all the previous posters have already done that. Please listen to them, Peter. Do you really want to have this surgery with all of the possible complications that you might have to deal with for the rest of your life, even if it does "cure" your OSA?

[Pugsy]

P.S. My ENT surgeon said to me his meaning of sucess of operation was to be free of cpap for good he has been in the business for 25 years.

And that would also be one potential definition of "success" for myself but I want to know exactly what constitutes "free of cpap" need.
Is it a general reduction in AHI by 50% or is it something else...and even with my non REM AHI of 12 (on my sleep study) I was having desats to 73% and then my REM AHI kicked in at 53 per hour.
Reducing my REM AHI by 50%....not success in my book.
Heck, even an AHI of 8.0 on my cpap machine now leaves me feeling like death warmed over.

I worked with doctors in the medical field for over 30 years. I know first hand that their idea of success isn't always my idea of success in any number of procedures.

But hey, you don't need to convince me that your doctor walks on water...they all think they do. If you are happy with him and trust him....that's what is important but you came to a cpap use forum wanting to know about surgical options. You aren't going to find any people here that aren't using a cpap machine and there are reasons why we choose to use the machine over surgical procedures.
The people who have had the surgery...well they wouldn't be here if it didn't fail would they?
The successful people...well they wouldn't have any need to be here would they?

Who are you trying to convince that this purposed surgery is worth the risk....us or yourself?
Your opinion is the only one that really matters. Given my experience with doctors in the past....I trust only up to a point and then I verify.
And listening to someone who thinks they always walk on water isn't my way of verifying something. They all promise you the sun, the moon and the stars.
When a person is a surgeon...everything looks like it can be fixed with knife. Sometimes it can...sometimes it can't.
What happens if you are among the 15% (docs % numbers) that it fails? Are you prepared to accept the problems that comes with having all that tissue cut on? If you are...hey, go for it. For you the reward may very well be worth the risk.
You don't have to convince me that your doc speaks the gospel and walks on water.

[The Latinist]

When a person is a surgeon...everything looks like it can be fixed with knife. Sometimes it can...sometimes it can't.
What happens if you are among the 15% (docs % numbers) that it fails? Are you prepared to accept the problems that comes with having all that tissue cut on? If you are...hey, go for it. For you the reward may very well be worth the risk.
You don't have to convince me that your doc speaks the gospel and walks on water.

I was about to post the same thing: as the saying goes, "when all you have is a hammer, everything looks like a nail."

[ems]

When a person is a surgeon...everything looks like it can be fixed with knife. Sometimes it can...sometimes it can't.
What happens if you are among the 15% (docs % numbers) that it fails? Are you prepared to accept the problems that comes with having all that tissue cut on? If you are...hey, go for it. For you the reward may very well be worth the risk.
You don't have to convince me that your doc speaks the gospel and walks on water.

I was about to post the same thing: as the saying goes, "when all you have is a hammer, everything looks like a nail."

Another +1

[DyingOnMyFeet]

I wish you all nothing but love on this forum thank you for all your time and answers if I do decide to have the operation I will let you know how sucessful it went for me - love from Peter from Australia A

[The Latinist]

I wish you all nothing but love on this forum thank you for all your time and answers if I do decide to have the operation I will let you know how sucessful it went for me - love from Peter from Australia A

Indeed, please let us know.

[chunkyfrog]

All medical procedures, drugs, and devices have unintended side effects.
The risk to benefit ratio would be simply too much for me, to say nothing of the cost.
I am fine with my mask--heavens, the masks are a world better now than five years ago.
While you are contemplating this risky and expensive procedure,
may I gently suggest you try a more minimal mask. Be patient with yourself,
And take it slow.
Love, froggie.

[herefishy]

Since this is the CPAP board, you might want to try other boards, Talk about Sleep or the Apnea board, who might have more experiences with other solutions.

[Julie]

There are terrific doctors in Australia who know about OSA and do not feel the need to push surgery - look up Monash Hospital (Melbourne) and Google them plus Cpap, OSA, UPPP, etc. to see what comes up... lots of good stuff should if you're patient.

[musculus]

How can he be so sure? I am wondering will the surgeon agree to pay you back if the surgery fails based on some objective measure.

Hi I saw an ENT surgeon who specializes in OSA surgery he said he could cure my OSA with a Tonsillectomy uvulopalatopharyngoplasty and tougue channelling procedure to shrink the tougue and stop it from blocking my airways - the coast is $5600.00 in a private hospital one night stay overnight anyone here had the op to cure their OSA this surgeon is adament that he can cure my OSA with this full surgical procedure - can anyone give some advice please - love to you all Peter from Australia.

P.S.

I Guess if someone here has had this op and it cured their OSA they would not be posting on this site anymore sorry if it seems like a dumb ? but just thought I would put it out there to see if their were any replys my surgeon told me the tougue channelling procedure was the last piece of the puzzle they needed to work out to completely cure OSA with surgical methods. They use a newly invented surgical instrument for the tougue channelling procedure to shrink the tougue safely and stop it from blocking the airways during sleep at night.

[Goofproof]

Both of you put funds matching the bill in a escro acct, if after five years you are still cured, pay him, if not he pays you, to cover z little of your pain and suffering. If you die from untreated sleep apnea, both monies go to your next of kin, they can try to get smarter with it. Jim