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Permalink Reply by RockRpsgt on August 24, 2009 at 8:14am

I can tell you that in my experience bariatric surgery is more likely to cure your apnea than throat surgery. I have had 2 patients beat apnea. 1 had a trach, and the other found a great bariatric surgeon. Out of the 20 to 30 studies that I have done post throat surgery 1 had an improved AHI. She is still an CPAP. I have read that the surgery has a 50% success rate. I have not seen those numbers in my studies. 0% success rate.

http://www.umm.edu/patiented/articles/what_surgical_procedures_slee...

Success Rates. Success rates for sleep apnea surgery are rarely higher than 65% and often deteriorate with time, averaging about 50% or less over the long term. Few studies have been conducted on which patients make the best candidates. Some studies suggest that surgery is best suited for patients with abnormalities in the soft palate who have mild sleep apnea that may or may not involve the tonsils. Results are poor if the problems involve other areas or the full palate. In such cases, CPAP is superior and should always be tried first. Many or most patients with moderate or severe sleep apnea will likely still require CPAP treatment after surgery.

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Permalink Reply by Saz RPSGT on August 24, 2009 at 12:31pm

Just to add to what Rock said.

Have you tried BiPAP yet?

Often "success" is defined by the surgeon as cutting your AHI in half. So if you stop breathing (and waking) 60 times per hour, now you're only going to choke yourself awake 30 times an hour. I'm guessing your AHI may be even higher with a pressure of 17cmH20.

It's very painful, and my lab will see these post UPPP patients back for CPAP titrations several years later. They are often more difficult to titrate because now instead of loose fleshy upper airway tissue to splint with CPAP, there is tough scar tissue that requires more pressure to move.

If you are truly not going to use CPAP, the trach is much more successful. Before proceeding you might want to question your surgeon and get some second or third opinions.

Jason

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Permalink Reply by Don Corbett on August 24, 2009 at 1:02pm

Thanks Jason I greatly appreciate your input.

Don

J. Sazama RPSGT said:

Just to add to what Rock said.

Have you tried BiPAP yet?

Often "success" is defined by the surgeon as cutting your AHI in half. So if you stop breathing (and waking) 60 times per hour, now you're only going to choke yourself awake 30 times an hour. I'm guessing your AHI may be even higher with a pressure of 17cmH20.

It's very painful, and my lab will see these post UPPP patients back for CPAP titrations several years later. They are often more difficult to titrate because now instead of loose fleshy upper airway tissue to splint with CPAP, there is tough scar tissue that requires more pressure to move.

If you are truly not going to use CPAP, the trach is much more successful. Before proceeding you might want to question your surgeon and get some second or third opinions.

Jason

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Permalink Reply by Henning on August 24, 2009 at 3:18pm

Don,

I am sure that this discussion is more complicated than that.

Success rate is a subjective scale.

If an operation can give you a better CPAP tolerance, then it's a success.

Maybe you cannot be cured from Sleep Apnea, but I believe if you can halve your required CPAP pressure you will feel it like a success.

I have just undergone a UPP (tonsils and the uvula). This is a UPPP without surgery on the soft palate.

Before this surgery I had a surgery on my nose (deviated septum, turbinate’s and sinus surgery).

Together it has given me a much better breathing, and for the moment I sleep without my CPAP. I await the outcome of my last sleep study.

But even if it turns out that I still need my CPAP, I would still describe these operations as a great success. Now I can tolerate the use of CPAP - unlike in the past.

I would recommend you to read a message from Dr. Steven Park:

http://www.sleepguide.com/xn/detail/2549090:Comment:14028

Henning

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Permalink Reply by Henning on August 24, 2009 at 3:55pm

I agree with Jason:

"Before proceeding you might want to question your surgeon and get some second or third opinions."

BTW: With regard to pain, I believe that my last operation is equivalent a UPPP.

OK! There was pain, but these could be largely eliminated by painkillers.

The worst were some few days where it was difficult to eat and drink. It is an effective diet.

But you will come to love ice cream.

Henning

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Permalink Reply by Don Corbett on August 24, 2009 at 6:08pm

Thanks Henning good advice!

Don

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Permalink Reply by Don Corbett on August 24, 2009 at 6:11pm

Thanks again Rock...

don

Rock Hinkle said:

I can tell you that in my experience bariatric surgery is more likely to cure your apnea than throat surgery. I have had 2 patients beat apnea. 1 had a trach, and the other found a great bariatric surgeon. Out of the 20 to 30 studies that I have done post throat surgery 1 had an improved AHI. She is still an CPAP. I have read that the surgery has a 50% success rate. I have not seen those numbers in my studies. 0% success rate.

http://www.umm.edu/patiented/articles/what_surgical_procedures_slee...

Success Rates. Success rates for sleep apnea surgery are rarely higher than 65% and often deteriorate with time, averaging about 50% or less over the long term. Few studies have been conducted on which patients make the best candidates. Some studies suggest that surgery is best suited for patients with abnormalities in the soft palate who have mild sleep apnea that may or may not involve the tonsils. Results are poor if the problems involve other areas or the full palate. In such cases, CPAP is superior and should always be tried first. Many or most patients with moderate or severe sleep apnea will likely still require CPAP treatment after surgery.

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