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Re: Getting Surgery and Want Advice...

Posted by sleepy-in-seattle on January 03, 2007 at 09:34:17:

In Reply to: Getting Surgery and Want Advice... posted by ChristopherJ on January 02, 2007 at 23:27:05:

I'm sure Dr JH follows the same phased protocol as the usual Stanford suspects.

Many people here have had experience with Dr KL. Hopefully some will post responses. It's a good idea to get that second opinion. I expect he will confirm the approach.

Re: botched surgeries- the UPPP is the only one of the procedures on your list that has ANY history of problems. The tonsillectomy and RF tongue reduction have a very safe profile.

My opinion - UPPP is relatively safe, however there are a few ENTs who should not be performing them.

The bigger isue is that UPPP just does not present a great picture of improvement. It is a high pain, low gain procedure. The most common results seem to be some less-than-major improvement that subsequently reverts after a year or two. The UPPP flap was developed to reduce post-operative problems, but I haven't seen any data that it is more effective at reducing apnea.

On the other hand, I have no doubt that all the soft tissue (huge tonsils and uvula) I had in the back of my throat was contributing to the severity of my apnea, even though it wasn't a root cause. After having UPPP/tonsillectomy, my *duration* of apnea during sleep tests never returned to the pre-UPPP peak.

I had the same concerns as you, being a singer and a public speaker/presenter. My surgeon said there was a small chance of becoming hypernasal after the UPPP. Thankfully, that did not happen and my voice became a little MORE resonant.

I was also concerned about the MMA, but my singing and speaking quality did not change at all due to that procedure.

I have considered both traditional (scalpel) tongue reduction as well as RF. I was told there was a SMALL chance for speech change, higher with scalpel, lower with RF - although the scalpel procedure would be better for actual reduction of apnea (I have a ginormous tongue). As a result, we decided to table it for now in favor of nasal valve reconstruction.

Good luck with your surgery!

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