corrected sleap apnea with surgery

Just wanted to let you all know I had surgery in June, osteotomy with genioglossus advancement. Surgery was a success. My airway is now 9mm at the base of my tongue and, after a sleep study for proof, I am able to sleep without my machine. Length of sleep has improved dramatically over the summer. I am amazed at how a good night's sleep changes the way I perform all day. ( It's one thing to know it. It's another to feel it.) I thank this forum and an insightful dentist for encouraging me to keep looking for answers. My apnea numbers were high, even on the machine, and I sought help for one very stressful year. I know surgery was a risk, but I felt as if I had to try. My advice for those who don't seem to be having success, is to keep looking and keep asking questions concerning treatment.. Because of this forum, I had a better understanding of my situation and what type of questions to ask, as well as a better understanding of the answers. I am grateful I 'googled' this site. I have suggested it to many. I learned that simply because one goes to a world renowned hospital, doesn't always mean the level of care will be better. I felt like I 'fell through the cracks.' Have not written to my former doctor yet, but that's next for me. I had four sleep studies in less than one year, many doctor's appts., much out of pocket expenses, and not once was this surgery mentioned as even an option. I am by no means saying that this surgery is a universal answer. I have a friend who is on a bipap and is successfully sleeping. It works for him. I keep you all in my prayers. I know how difficult a journey this is.

Congrats on your success. I know you had quite a struggle. I am happy for you.
There is a part of me that wishes surgery would fix my problem but alas it won't. In fact surgery on my neck probably caused the problem. My obstructions are farther down the airway.

I just read your post. So glad surgery worked for you. I read your post finding my mind longing for the same success. Knowing that I could just take a nap anywhere, travel without my machine, . . .

How does one find out where blockage occurs and if surgery would be as successful from one person to the next?

Congratulations.

Let me point out that this is the "big deal" surgery, not the "quick and dirty" UPPP surgery that tends to get recommended a lot.

If anyone is considering surgery, do a lot of research. There are several types of surgery, and some of them have a higher success rate, but are a much bigger deal in terms of what's done and how you recover from them.

gasp wrote:How does one find out where blockage occurs and if surgery would be as successful from one person to the next?

That's the million dollar question. If you read the research, you get the sense that they have some way of knowing, don't ya'? You'd think you could walk into someone in the know's office and they would identify the site of the obstruction, right? That's what I thought anyway. Sure it's possible to say that correcting a deviated septum is going to minimally help in tolerating nasal CPAP. And if someone's tonsils are touching, it can only help to remove them (how much, who knows). Beyond that, it's all a great mystery. Yes, I've become a real skeptic! And I say all this as someone who believes I did get something out of my surgery, and I don't regret it a bit, although clearly it was not a cure.

To the OP, I'm glad you were cured. If you have insights into how your surgeon knew that THAT particular surgery would work for you, that would be interesting to hear.

Congratulations on getting off CPAP and good for you for confirming it with a PSG! It sounds like a hard, painful, and expensive process, but it's great that it paid off in the end for you.

Nance...congratulations! That is a life changer...and I know you are so happy! Good for you for doing your homework.

I had been being treated at a world renowned hospital for over one year. After 4 sleep studies, a cpap, bipap, and asv machine, my apnea was never corrected. I remember my sleep doctor saying my throat looked crowded, but my tonsils and adenoids had been removed as a kid, and she made no further suggestions, only kept upping the pressure and switching machines. In February, during a routine dentist's visit, I whined about how I felt and that the sleep doc had mentioned my throat looked crowded. I felt like I had 'fallen through the cracks.' My dentist recommended a jaw and facial surgeon who was affiliated with a dentist who treated tmj and apnea related sleep disorders. I made an appointment. After a cat scan of my head and neck, the doctor recommended a nasal endoscopy. Had one the next week. Saw that my windpipe was constricted at the base of my tongue. Was surprised that no one had commented on this before. Suggested the osteotomy and genioglossus advancement procedure as alternative to braces for a year and breaking my jaw to advance it. At my age (over 50)statistics show often the jaw nerve didn't regenerate and numbness was a result, making the lower lip pretty useless. I saw my internist. I also dropped my previous sleep doctor and found a new one. Saw him before the surgery and he was quite confident , after reviewing my records that this would work. Yes it was risky. Yes it was expensive. But those 4 sleep studies were expensive too and they seemed to be pretty worthless concerning how to treat my sleep apnea. The machines weren't working(numbers always stayed in the upper teens) and I had already been responsible for two machines(DME problems is a whole other story.)...Argued with the DME about the asv( given to me in January after the 4th sleep study)...Had it in my home one night,up most of the night feeling like I was trying to breath in a wind tunnel, hardly using because I was up most of the night walking, trying to move the air it had forced into my abdomen, and gave it back.. Asked for my old machine(bi-pap) back and used it until my surgery. It was better/safer than sleeping without one. This surgery was one of the most painful surgeries I ever have had....for about two weeks. Vicodin was my friend. Looked a bit like Jay Leno until the swelling went down. But the results were immediate. No snoring. I actually felt refreshed when I awoke. My insurance covered some of this procedure. Bottom line..If the machine works for you it is a blessing. Use it. The strain on your organs because of sleep apnea is amazing. Didn't trust not sleeping without the machine so, thanks to this forum, I purchased a pulseoxometer to wear when I slept post-surgery. I saw the results immediately. No oxygen dipping abnormally at all. Had a sleep study the beginning of August and passed...Only thing that kept waking me up was the hard mattress! I did do my homework, trusted my surgeon, anesthesiologist, and internist, and took a leap of faith. If anyone has any more questions, I will gladly answer them as honestly as I can. I will be forever grateful for this forum. The knowledge I gained from the people here who read what we write, comment, make suggestions, and understand, put me on a path that changed my life.

SleepingUgly wrote:

gasp wrote:How does one find out where blockage occurs and if surgery would be as successful from one person to the next?

That's the million dollar question. If you read the research, you get the sense that they have some way of knowing, don't ya'? You'd think you could walk into someone in the know's office and they would identify the site of the obstruction, right? That's what I thought anyway. Sure it's possible to say that correcting a deviated septum is going to minimally help in tolerating nasal CPAP. And if someone's tonsils are touching, it can only help to remove them (how much, who knows). Beyond that, it's all a great mystery. Yes, I've become a real skeptic! And I say all this as someone who believes I did get something out of my surgery, and I don't regret it a bit, although clearly it was not a cure.

To the OP, I'm glad you were cured. If you have insights into how your surgeon knew that THAT particular surgery would work for you, that would be interesting to hear.

Hopefully someday they will treat apnea more scientifically and I imagine at that point our therapy will be looked at as the dark ages!

Nance, in your other post you said that

Doc opened up my windpipe at the base of my tongue from 3mm to 14 by pulling my chin and tongue forward.

Can you tell me if the chin was actually moved (vs say, supplementing)?

My understanding of a plain ol' Genioglossus Advancement is that the chin (mandible) stays put.

TIA.

deltadave wrote:Nance, in your other post you said that

Doc opened up my windpipe at the base of my tongue from 3mm to 14 by pulling my chin and tongue forward.

Can you tell me if the chin was actually moved (vs say, supplementing)?

My understanding of a plain ol' Genioglossus Advancement is that the chin (mandible) stays put.

TIA.

Reply:

It's a pity that the OP has not replied. My understanding is that you, "Not Muffin"wanted to verify if it was really the surgery method or a dental mandibular appliance.
Many CPAP users could get rid of their CPAP for good if they qualify for a Mandibular Appliance which would open the airway by about half an inch more, during sleep and it is NOT invasive.

See here the diff.:

Surgical Treatment of Obstructive Sleep Apnea
Upper Airway and Maxillomandibular Surgery
Link:


http://pats.atsjournals.org/cgi/content ... 2/193#FIG3

VS.

Mandibular advancement splint
Link:

http://en.wikipedia.org/wiki/Mandibular ... ent_splint

To use this method, in my case, my dentist would take an impression of my teeth, for $100, and send to the technition. If the technician says that it is OK then I would add $1,900 and get the splints, and moth ball my APAP. I would wear the splints only during sleep (like a night guard)