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Re: Genioglossus Advancement or Not?

Posted by woody on February 23, 2004 at 13:23:33:

In Reply to: Re: Genioglossus Advancement or Not? posted by westernjoe on February 23, 2004 at 11:37:42:

Maybe I'm way out of line here but I feel a little angry with the medical establishment most particularly ENTs. I posted a response last week that doesn't seem to have loaded so I'll post my thoughts again. I have had miserable success with ENTs. Most don't seem to have bothered to follow the progress of Obstructive Sleep Apnea research. And that is a shame. The UPPP is in the ENT's domain. As far as I'm concerned it's a waste of time and has a dismal success rate. If you enjoy pain for its own sake try the UPPP. Granted some OSA may be due to a deviated septum but the vast majority are due to too narrow an opening deeper in the throat. During sleep the tongue relaxes and settles against the wall of the trachea closing off the air passage. Take a little time and pick up an anatomy book. The tongue recedes fairly deep in the throat. The logical step is to move the tongue forward. The most successful means of surgery is the Maxillomandibular Advancement. As the lower jaw is moved forward the tongue moves forward as well. The tongue is fairly rigid and goes from the lower mouth to a point deep in the throat. The result is a much expanded passageway over considerable length. The MMA is simply the most successful operation available for OSA. Statistically, I believe it offers a 93% success rate. And that not bad. However, the trick is to find an oral surgeon who has experience with sleep apnea. Most oral surgeons have used the MMA for purposes other than sleep apnea. But unless the surgery advances the jaw by 10-12mm it might not be adequate. So spend the time to find the right doctor. I think even the Stanford protocol might be dated since they use the UPPP as the first stage. This is cautious and probably irrelevent. Perhaps you could try contacting the Univ. of Michigan hospital. Their alternative to sleep apnea clinic is pretty good.

I had surgery Nov. 19. My operation was about 8 hours long. There was very little pain associated with surgery other than a massive hangover from the anasthetic. Removing the breathing tube was not pleasant. And I felt very tired for a good 1 1/2 months. However, I had follow up sleep study 10 days ago. The results show apneic episodes down from 42 to 3 per hour and oxygen saturation never less than 93% up from 82%. I can live with that.

I apologize for the length of this posting but it seems necessary to have some discussion and debate over surgical procedures. I feel there is a need for more disemination of information to the medical community. There are alot of people who struggle with OSA and they certainly deserve the best medical care available.

-woody

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