Posted by Perry on August 09, 2002 at 04:24:16:

In Reply to: Poor Outcome UPPP Operation posted by Paul on August 08, 2002 at 22:32:16:

Yours is a typical case.

Please be advised that ENT surgeons measure the success of an operation totally different than you do. They got paid didn't they....

The long term (3+ years) treatment success of UPPP and all other forms of throat surguries for OSA is absimal. Many many studies have been done and they consistently report that aproximately 50% of surgury patients achieve about a 50% reduction of AHI/RDI. Such surguries can even make the problem worse for a small percentage of people.

The majority of people who have these surguries end up not properely treated and are often put back on PAP.

The only cases where such surgury is highly effective is where a person has a specific throat abnormality (such as extreemly large tonsils), and that obnormality can be fixed. Somnoplasty of the lower toung can be effective for some people in this case (but in general somnoplasty is not overwhelminly successful and 3+ year data is only now beginning to roll in).

Several years ago the non-ENT OSA treatment professionals came also close to outright asking the surgeons to produce evidence that throat surgury worked at all. I will admit that the quality of surgury studies greatly increased at that point.

Nose surgury to fixed a severely deviated septum (this is not throat surgury) is also highly effective. Nasal sugury for turbinate (or whatever the word is) is only moderetely successfull for OSA - but often highly successfull for ease of breathing and nose usage.

MMA, which physically relocates your upper and lower jaw is also hightly successful for those with the right facial structure (and the surgeons who do this work will not touch someone with the wrong facial structure now due to the inital results of MMA. Here is a case where the surgeons paid attention to the success data on decided to weed out the non-success cases). However, MMA is major surgury and cost about $50,000 plus dental work to realign all of your teath in either the upper or lower jaw (so you have proper bite again).

As far as your case (and other people reading this). ENT surgeons don't get paid unless they are doing surgury - thus they have an inherent conflict of interest and many will recommend surgury over other options (even if surgury is the least effective option).

I suggest that you follow up more on the Non-CPAP forum.

Perry

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