A great place to start Disorder information source Rated and Reviewed Sleep Links Entrance to all monitored Sleep Forums Search all of Sleepnet.com


Apnea Forum
Posting


Archived Apnea Forum94 viewing only. To post a new topic go to the Apnea Forum Homepage.

Re: Re: Re: Who are the recognized OSA experts

Posted by Perry on June 16, 2002 at 05:43:43:

In Reply to: Re: Re: Who are the recognized OSA experts posted by coquina on June 16, 2002 at 04:08:23:

You should direct further inquiries on this subject to the Non-CPAP forum. However, I will provide a summary answer below.

Unfortunately, the information you want is there - but it does not work out to be a generally successfull approach.

Obstructive problems are typically caused by problems in at least 3 different areas of the throat, and many people have multiple areas of problems. In addition, the verry act of removing tissue from one area can cause further weekness in that area or ajoining areas (and can make the OSA worse).

Thus removal of throat tissues is not very successfull on a whole if your goal is to get off of CPAP. The long term averages (3 year success rate) for all throat tissue area removals are that 50% of people have their event count reduced by 50%, and the vast majority of people still need some form of PAP.

The exception to this is where one specific problem can be identified by several different OSA specialist. For example, if you have very unusually large tonsils causing the problem, then reduction or removal of the tonsils does indeed solve the problem. Unfortunately, this type of "one area" problem only applies to the very very few. Be sure that at least 3 different unrealated 'surgeons' identify the same specific area. Surgeons tend to recommend surgury (its what they do) and many of them consider the surgury a success if there is any reduction in events. The other key success paramater that surgeons use is that they get paid for the surgury. Just be sure you understand what they are defining as a success (and ask them for published medical studies showing that their recommended surgury is sucessfull).

Radio frequency ablation of the lower tounge (somnoplasty) is the latest rage - but I have not seen anything that indicates that its long term success rate (in getting people off of CPAP) is any different than any of the other throat procedures.

I will mention that all of the throat procedures tend to be highly effective at eliminating snore, which can reduce the effectiveness of AutoCPAP as all AutoCPAPs (in the US) trigger from snore.

Some people have used these procedures to reduce their OSA from "severe" to "moderate" knowing that they will still need PAP.

MMA is highly successfull for the patients with the right facial structure. But that involves breaking/cutting both the upper and lower jaws and moving them forward (clamping them into their new position with a plate, along with considerable dental work. It is major surgury and can have some significant side effects. MMA is new enough and experimental enough that you would problably need precertification from your insurance company (if they will pay for it - $40,000 +).

Perry

Follow Ups:


Archived Apnea Forum94 viewing only. To post a new topic go to the Apnea Forum Homepage

  • IMPORTANT : Information not intended as medical advice. If you suspect that you have a sleep disorder you should seek care from a qualified professional. Read Terms of Use.
  • The Sleep Forums are not to be used for commercial purposes.
  • Commercial products and services are not endorsed by Sleepnet.com.
  • Sleep Deprivation due to Sleep Apnea and insufficient sleep are common and can present as insomnia, narcolepsy, or idiopathic hypersomnia. In infants and children sleep problems commonly present themselves as ADD or ADHD.


Copyright ©1995-2005 Sleepnet.com., All rights reserved