Re: UPPP-Is it so bad?
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Re: UPPP-Is it so bad?

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Posted by bruinmd on March 03, 2009 at 07:55:13:

In Reply to: UPPP-Is it so bad? posted by sleepsurgeon on February 27, 2009 at 20:50:07:

The problem with soft-tissue surgeries in general is that the
studies that have been done to support their use (in general) or
lacking in intellectual integrity- as a whole. Each study needs to
be taken with a grain (sometimes grains) of salt. What is
considered a "success" often only translates to a successful
mortgage payment. A decrease of the RDI or AHI by 50% or to
less than 20 is a total sham.

I think there is some literature that "holds mustard" but I think
those are few and far between. Most ENT's who perform these
surgeries have no business doing them. When I talk to a
community-based ENT about sleep apnea, it becomes quite
clear they don't know what they are talking about.

And further, I would be curious for each surgeon to figure out
what their "number needed to treat" a patient is regarding a
sleep apnea procedure. In other words, that surgeon should be
able to tell me roughly that out of 20 people have a certain
surgery, X number would be likely to have a long term success.
(Note- not just temporary success. I am talking over 2 years of
long term success. And I have a feeling that most surgeons
would not be open to giving this type of information. And I bet
the number needed to treat for the UP3 is well under 1 in 10. I
would love any surgeon to post 20 consecutive patients with a
given surgery with pre a post sleep studies with at least one
sleep study 2 years later. Then you may have something worth
talking about in the soft-tissue literature. Until someone can
back up the results of their UP3 and other soft-tissue literature,
it is just talk (and a lot of wasted time and money on our part).

Sorry to be so blunt.

Bruinmd

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