Re: Mystery solved! ever heard of "palatal prolapse" (new article)?
Posted: Sat Jul 07, 2018 8:04 pm
Really interesting thread. My dad has similar obstructive patterns. Any updates on your progress, yrnkrn?
You don't mean to imply that surgical interventions and PAP therapy are mutually exclusive, right? Shouldn't the different therapies work adjunctively? I don't know if jaw surgery would contraindicate PAP therapy, I haven't heard of such a thing. Also doesn't jaw surgery fix multiple points of obstruction? My memory is rough, but I've read that bimax surgery has a very high success rate at upwards of 90% and a cure rate of about half of that.jnk... wrote: ↑Thu Jul 05, 2018 8:40 amRecognizing the location and mechanism of airway narrowing and airflow routing may be interesting, but it is, to the best of my knowledge, not significant for titration of airway-pressure-based treatments for OSA.
The study adds to knowledge of mechanism and location, but it is not clinically significant beyond that, as far as I can see. EFL or no EFL, the gold standard remains well-titrated and well-executed PAP therapy.
Obstruction may occur first in a particular way in a particular location, but experience has shown that if you simply try to surgically, or otherwise, address the dynamics of one location, obstruction for the OSA-prone patient then just begins to occur at the next location in the airway most prone to obstruction. This is one of the primary reasons that surgical and jaw-position approaches to OSA are much less successful than PAP.