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Sleep Surgeon Question 19

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Question 19 - Help, what are my OSA treatment options.

From: Bill L.

I am a 43 years old male. I was diagnosed with severe OSA more than 10 years ago. My doctor started the treatment with CPAP. It was great for about 2 years, then I started to have problems with air forced into my nose and come right out of my mouth. I tried full-face mask, but that did not help.

Over the next 10 years, I have had many surgeries by many different doctors. I have to say I’ve already been through all of the available surgeries, but tracheotomy and Maxillomandibular Advancement. The last doctor I saw put me back on CPAP at 12 cm.

I wake up many times during the night, and recently I notice that every time I wake up I feel my heart is pumping really fast and hard, and in the morning I have pain in my chest. I went to the doctor and he recommended either tracheotomy or Maxillomandibular Advancement. I feel it is too extreme for either procedure.

Can you help me? Is there anything else I can do? Is there a good doctor in the bay area you can recommend?

Answer Provided by Dr. Kasey Li
August 16, 2007

The treatment options for severe sleep apnea are limited. It seems that you have already tried number of operations without success.

At this juncture, the only realistic surgical options would be tracheotomy or maxillomandibular advancement. In my opinion, maxillomandibular advancement is much more acceptable for patients.

I would recommend that you speak with some patients who have had the operation so you can get a patient’s perspective on the operation.

Good luck.

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