Posted by bruinmd on February 07, 2009 at 11:08:08:In Reply to: Re: What are my options? posted by SomeDudeinCali on February 02, 2009 at 13:00:27:
The area behind the soft palate is called the oropharynx. When
you swallow, the muscles of your pharynx close off the space
between the soft palate and the pharyngeal wall in the back of
your throat. This keeps the food and liquid you swallow from
going back up into your nose. But if there is too much soft
palate removed, you lose your ability to close off that space.
And your speech also becomes more nasal. That has been the
problem Gremlin has had since his surgery. So when you have
the MMA, your mouth is brought forward. So this increases the
space behind the soft palate and the back of your throat. If the
UP3 was done before the surgery, this increases the chance of
having soft palate too far forward.I think the less of the palate removed the better.
As far as the lingual tonsils- the guy who had the lingual
tonsillectomy likely had large lingual tonsils. The lingual tonsils
are on the back of the tongue (tongue = lingual). Not everyone
has large lingual tonsils. Tonsils are part of the "lymphoid
tissue." Lymphoid tissue is the site where the white cells are
made that help fight infection. Over the years- they can
increase in size following repeated respiratory infections. The
adenoid tissue is just above the soft palate behind your nasal
passage. That has a similar role as the tonsils. But in adults-
they usually don't have much of a prominent role in your
immune system (main role is in early childhood). But they can
affect our airway and contribute to sleep apnea. So I don't know
how big your tonsils and adenoids are. But typically- they are
not a major player in adult sleep apnea.There is a relatively new procedure that can be done to remove
the lingual tonsils. It is called "coblation" and is used in children
commonly to remove the tonsils and adenoids. It can also be
used to reduce the size of your tongue muscle. Basically, insert
a "wand" into the muscle of your tongue and can liquefy the
tissue. It may offer significant promise for sleep apnea but it
has not been well studied yet. Here is a website of an ENT who
does the procedure. I do not know him personally and know
nothing about him. I have just looked at the site for my own
interest.Many people with sleep apnea need to go through the process
and try less invasive procedures. I think in the end- most
people do not have a long lasting benefit from the less invasive
procedures. Of course- there will be exceptions. But again-
ask your ENT for 5 consecutive patients who have had the
procedure he is recommending for you at least 6 months ago
and see how they are doing. Just asking for a few patients may
not help because any surgeon can have a few good results over
time. But asking for at least 5 consecutive patients at least 6
months ago will give you a better idea. And make sure it is that
long ago because there is significant relapse with these
procedures. I bet the ENT squirms when you ask for this.