Posted by Captin Cannuck on January 17, 2009 at 15:59:01:In Reply to: Re: Z Palatopalsty posted by Gremlin on January 15, 2009 at 20:36:26:
Dear Gremlin,
I know well about your situation. I often think about you. I know you are facing a gamble.
I believe that you had LAUP, as I did. For those reading this who don't know, LAUP is a laser variation of UPPP. It was aggressively marketed (and still is) for treatment of social snoring. Basically, instead of using a scalpel to remove the uvula, a laser is used. It is said to be even more destructive than UPPP.
I know of many many medical authorities who have written on the adverse after effects of UPPP. In this thread I have only cited a few of them. I could go on and on, and I may well do if I can save even one person from a life of suffering by giving good counsel.
As for what Dr. L. said, you can see it in this site on the "ask the expert section". I has a few comments on UPPP and LAUP. See question 34 for example. He is responding to Mrs. Capistrano who ran into trouble after UPPP.
Dr L wrote as follows:
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Quotation:
"One should ask whether UPPP is a good operation for sleep apnea. From my point of view, the answer is no. The important issue here is that although UPPP does help some patients with sleep apnea, it can create side effects such as swallowing difficulties, throat dryness and sensitivity, as Capistrano is experiencing (LAUP is worse).The central problem is that the operation is flawed in that the uvula is removed. Additionally, delicate tissues are replaced by scars which also contribute to the side effects. I have always lectured on this topic as I have opposed the removal of uvula for many years. I never believed that uvula contributed to sleep apnea and have designed operation to preserve the uvula while expanding the airway (http://www.sleepapneasurgery.com/pharyngoplasty.html).
The key in sleep apnea throat surgery is not how much tissues are removed to open the airway, but is how the airway can be improve by making them less floppy. By preserving important tissues, side effects can be minimized.
KKL"
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As for Dr. Dement (search his bio on Wikipedia to see his credentials). You can see his opinion on UPPP by reading a book called "The Promise of Sleep". It is a very famous book which is likely to be in your local public library. Dr. Dement says something to the effect that usually when UPPP is performed and a follow up sleep study is done, there is usually nothing gained. He explains that most people with OSA have multiple points of obstruction, and sometimes after UPPP the people get even worse. Dement goes on to talk about the Stanford Protocol operation, the first stage of which involves UPPP and then a second stage involves MMA and GA surgery. As we know, that protocol has produced good effects. Nevertheless, we know by the work of Dr. Jeffrey Prinsell in Atlanta, that equally good results were obtained when UPPP was not included and the second stage of the Stanford Protocol was administered. Basically, it is the MMA and GA that are doing the work. UPPP is just along for the ride in most people. Sure, there are some who may actually have some sort of bizarre deformity where a conservatively administered UPPP might be beneficial, but in the majority of people who are routinely given that operation, it is unwarranted and is actually detrimintal.The bottom line is that MMA and CPAP therapy is what helps people to cope with sleep apnea.
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