GENNIOGLOSSAL ADVANCEMENT-- STANFORD

rudyrx · Post by **rudyrx** » Sat Sep 16, 2006 11:30 pm

I AM HEADED TO STANFORD UNIVERSITY FOR A GGA ON THIS UPCOMING WEDS SEPT 20TH. I HAD A UPPP ABOUT 12 YEARS AGO WHICH WAS OF HELP FOR ABOUT 5 YEARS, THEN BACK TO CPAP. NOW AM GOING TO TRY THIS AFTER 4 YEARS ON CPAP. ANYONE GOT ANY COMMENTS OR SUGGESTIONS THEY WOULD BE GREATLY APPRECIATED.
I SAW DR H. THERE LAST YEAR AND HAVE FINALLY DECIDED TO HAVE IT DONE BY HIM. TIRED OF THE OLD CPAP JUST LIKE THE REST OF YOU PROBABLY ARE.
ANYONE THAT HAS HAD THIS PROCEDURE OR ADVISE WOULD BE WELCOME. THE MOST PAINFUL PART OF THIS FOR ME IS THAT MY INSURANCE (BC-BS) IS NOT GOING TO PAY FOR IT SO IT IS COSTING ME BIG $$$.
RUDYRX

kteague · Post by **kteague** » Sun Sep 17, 2006 1:12 am

Not positive, but I think that's what a college student on this forum had done recently who goes under name of SWORDZ. Might want to search him out and send him a message. Hope the procedure meets your expectations.
Kathy

Offerocker · Post by **Offerocker** » Sun Sep 17, 2006 1:27 am

OK, I'm game: What is a GGA?

Thanks!

Snoredog · Post by **Snoredog** » Sun Sep 17, 2006 1:48 am

Offerocker wrote:OK, I'm game: What is a GGA?

Thanks!

They take your tongue muscle which is a complex muscle sometimes considered an organ that is attached to the back side of your chin about half way from the lower lip to the bottom of the chin.

They first cut out the bone around where the tongue is attached to the chin bone pull it forward and rotate it 90 degrees and reattach with screws and bone grafts. I have no idea if your tongue rotates but where it attaches it does.

The procedure effective pulls the tongue forward where it no longer blocks the airway. If the GAA is still not effective, they may suggest a MA or mandibular advancement. This is where they cut the lower jaw bone and extend it effectively moving the tongue forward more. This proceduce is extensive and requires ortho work before and after.

The GA is what I go for before any MA. Most OSA is from having a large tongue or one that relaxes into the airway when you sleep.

krousseau · Post by **krousseau** » Sun Sep 17, 2006 8:42 am

That surely gives new meaning to being twisted.

Good Luck!

Offerocker · Post by **Offerocker** » Sun Sep 17, 2006 10:04 am

Snoredog:
Thank you so much for explaining it for me.
...is this AFTER the a decrease in size to the uvula has been unsuccessful?

It sounds to me that one's BITE would then be off, since teeth are attached to the lower jawbone. ...that would be for the MA, right?

I'm inferring then that they must take BONE (to which the tongue is attached) due to the tongue being such a strong muscle that cutting/reattachine it would be futile?

I've had (voluntary) spinal surgery, with 9 of them being fused, body cast, etc. but THIS sounds like an extreme measure to me...yes, but it must be necessary, eh?
Is this done solely due to Apnea-related issues, in that the highest pressure setting does no good?

Too bad it's that part of the tongue, that can't just be 'snipped off' ..(while you bleed like heck)

I'm hurting already, and losing weight, just trying to imagine it all. I'm not squeamish, but it does sound radical.
OK, my surgery may have sounded radical, but it was due to scoliosis, for which there's no 'treatment', thus my question re apnea related.

I'm ready for more information if there's more. Oh, and is this considered 'life-threatening' for insurance purposes?

My heart goes out to anyone who has this procedure performed.
On a lighter note, I hope they make a perfect cut so that it still fits after that 90-degree turn/twist. Also, how many times can they 'twist' it? does it make a lump that gets in the way? Wow, my imagination is running wild...what's to keep it from just 'flipping back anyway????

Goofproof · Post by **Goofproof** » Sun Sep 17, 2006 11:14 am

It sounds to me like a little hose time is the best answer, no invasion and little pain, but in this worlds it takes everything. Hose On, for me! Jim

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): hose

Offerocker · Post by **Offerocker** » Sun Sep 17, 2006 1:53 pm

Goofproof wrote:It sounds to me like a little hose time is the best answer, no invasion and little pain, but in this worlds it takes everything. Hose On, for me! Jim

Jim: Oh, there' have been times I would have just loved to be able to 'plug' a hose to my throat in order to get away from the headgear, masks, leaks, sweating, alergies to certain things associated. I'd opt for THAT!

Goofproof · Post by **Goofproof** » Sun Sep 17, 2006 2:03 pm

I've had my fill of invasive cuts, but I have one coming up on 9/21, I'd gladly hook up a second hose and mask to avoid another knife. Jim

jeepdoctor · Post by **jeepdoctor** » Sun Sep 17, 2006 7:39 pm

Someone asked what GGA means. Here is the verbiage and illustrations from Dr. Nelson Powell's Palo Alto clinic web site.

Genioglossus Tongue Advancement

This is designed to place tension and improve the airway behind the back of the tongue. The genioglossus is the main tongue muscle, which holds the tongue forward. During sleep, this muscle relaxes and often allows the tongue to fall backwards into the airway. This muscle attaches to the inside of your lower jaw to a tiny projection of bone the size of your little fingernail. If a segment of bone containing this muscle is pulled forward and stabilized, it can stabilize the airway space behind the tongue. This procedure does not move the teeth or the jaw and can be done in some without the need for a general anesthetic.

For a detailed treatment rationale indications and outcomes, see Management of Sleep-Disordered Breathing.

The pictures didn't reproduce. Here's the link http://www.sleepsurgery.com/genionglossus.html

Offerocker · Post by **Offerocker** » Mon Sep 18, 2006 1:19 pm

Thanks, Jeepdoctor! I'm going to visit that site; am sure it will be interesting.

rudyrx · Post by **rudyrx** » Mon Sep 18, 2006 2:39 pm

Thanks for all of the comments from everyone. I head out tomorrow am for Stanford Univ and surgery. I am still fighting my insurance company on this procedure. They are going to pay for the radiofrequency and the hospital stay, but not the GAA.
Today I officially appealled their decision. Hopefully they will come to their senses and pay for the whole thing or I am out of pocket about 10 grand.$$$
Thanks for all the support and PM that were sent. When this is over and I am back I will give you all my take on this procedure.
CPAP.com does an ecellent job in suplying us with this forum. I want you all to know that I am NOT against CPAP therapy in anyway and it works for many of you. I am just tired of waking up in rthe morning with my mask laying next to me or on the floor and feeling lousy. I am hoping this will give some resolution to a problem that I have had (OSA) for over 20 years.
RUDYRX

snoozie_suzy · Post by **snoozie_suzy** » Mon Sep 18, 2006 5:38 pm

Good Luck Rudy,

I will pray for you tonight that everything goes smoothly and the surgeons hands are precise.

Please keep us posted on how you are doing once you are feeling up to using the computer.

God bless,
Suzy

birdshell · Post by **birdshell** » Mon Sep 18, 2006 10:28 pm

As you know, surgery in and around the mouth, nasal passages, sinuses, etc. can be very painful. You are brave and bold.

I had 5 surgeries in a year. It can be tough on the body and mind, but surgery usually makes one's life better. I hope that you have a great result. My thoughts and prayers are with you.

How about those who pray giving a little one for the insurance company to pay for at least more of the surgery (if that is in the plan!)

Offerocker · Post by **Offerocker** » Tue Sep 19, 2006 5:49 am

birdshell wrote:
How about those who pray giving a little one for the insurance company to pay for at least more of the surgery (if that is in the plan!)

Good idea.
Prayers for everyone involved in Rudy's surgery and recovery will go out.
Also, that this procedure will be the solution to Rudy's problem!

GENNIOGLOSSAL ADVANCEMENT-- STANFORD

GENNIOGLOSSAL ADVANCEMENT-- STANFORD

Upcoming surgery