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ENT APPOINTMENT - WHICH OPERATION?
Just back from my ENT post-op appointment where it's been confirmed the SMD laser operation I had in August has not been a success. Initially, it was fantastic and I was able to breathe for the first time ever through my nose, but 2 months later the problem is back (coinciding with the central heating coming on now winter's coming). The ENT surgeon offered me 3 operations:-
1) Turbinectomy, to remove part of the turbinates
2) Septoplasty for my deviated septum, and
3) Surgery on my large soft palate.
I was quite shocked to be offered all 3 operations at once and I also pointed out that I've heard the septoplasty and soft palate surgery aren't always that successful, as well as being painful. He said the choice is up to me, but to save me having further operations he would do it all at once - yikes! He also pointed out that due to me not being overweight, the palate operation is likely to be more of a success (not sure why!). At this stage I've opted for the turbinectomy, seeing as the first minor turbinates op proved very successful at first. I can, however, ring to op for the other procedures too, but I wanted to research them first and ask the knowledgeable people on this site what they thought.
I did learn today that I have sleep apnea due to the soft palate issue, a receding jaw and a large tongue base (no 'hope' for me is there? lol), along with the nasal stuffiness!
Thanks for your time in reading my post!
1) Turbinectomy, to remove part of the turbinates
2) Septoplasty for my deviated septum, and
3) Surgery on my large soft palate.
I was quite shocked to be offered all 3 operations at once and I also pointed out that I've heard the septoplasty and soft palate surgery aren't always that successful, as well as being painful. He said the choice is up to me, but to save me having further operations he would do it all at once - yikes! He also pointed out that due to me not being overweight, the palate operation is likely to be more of a success (not sure why!). At this stage I've opted for the turbinectomy, seeing as the first minor turbinates op proved very successful at first. I can, however, ring to op for the other procedures too, but I wanted to research them first and ask the knowledgeable people on this site what they thought.
I did learn today that I have sleep apnea due to the soft palate issue, a receding jaw and a large tongue base (no 'hope' for me is there? lol), along with the nasal stuffiness!
Thanks for your time in reading my post!
Views: 417
Replies to This Discussion
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Permalink Reply by Steven Y. Park, MD on
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Kath,
I would go for the nasal procedures and skip your palate procedure, unless your surgeon offers to do something to shrink your tongue (or widen your jaws). You most likely have 3 level narrowing, and treating only one or two areas has a significant chance of failure. For most people with small jaws, the space behind the tongue is too narrow. One option is to optimize your nasal breathing, and then look into an oral appliance to advance your jaw forward (or use CPAP). A septoplasty in my experience is not painful for most patients, with very few people talking pain meds, and without any nasal packing, you can breathe right away, and go home a few hours afterwards. Also, make sure that your nostrils are not too flimsy. Sometimes, it can be a challenge to figure out if you need to address your nostrils as well. Either way, good luck with your procedure(s).
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Permalink Reply by Kath Hope www.hope2Sleep.co.uk on
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Thanks for the reply Dr Parks and I'm relieved you suggest to avoid the palate procedure. The reason I was hesitating about the septoplasty is because my own daughter had that op last year and her nasal stuffiness is no better. I don't think I'll get away with no nasal packing though, as the surgeon said he would want to pack my nose even after just the turbinate surgery on it's own :( He also said he would want me to wear a 'mouth only' cpap mask, which I need to research into, as I'm not sure if there is one, though I vaguely recall Fisher Paykel having one. He said he wouldn't want any air pressure up my nostrils for a few days. Wish I was in New York (sigh.....)
I'm very grateful to your reply though, thank you!
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Permalink Reply by Mary Z on
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Kath, so sorry your surgery was not a success. And I thank Dr. Park for his response about the further surgery.
The Oracle by Fisher and Paykel is a mouth only mask, with nasal plugs, which you would not have to use. As I remember it comes with two sizes of mouthpieces. I tried one about a month ago, but had leakage around the nostril plugs and so could not use it. I found the mouthpiece to be very comfortable, though.
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Aw thanks Mary - you're a gem :) I was just going to start searching for it. Will be seeing Fisher Paykel at the next month's support group meeting, so will have a word with them.
Mary Z said:Kath, so sorry your surgery was not a success. And I thank Dr. Park for his response about the further surgery.
The Oracle by Fisher and Paykel is a mouth only mask, with nasal plugs, which you would not have to use. As I remember it comes with two sizes of mouthpieces. I tried one about a month ago, but had leakage around the nostril plugs and so could not use it. I found the mouthpiece to be very comfortable, though.
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Permalink Reply by Mike on
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Kath -- your situation is so complicated, i definitely feel for you. Compounding that is the UK system of not being able to "shop around" for a doctor like Dr. Park who specializes in treating sleep breathing disorders. I know that over there you are assigned the ENT at your local hospital, and that's sort of the end of the story if you can't afford to go beyond the publicly funded option.
I don't recall, but remind us of whether you've experimented with nasal irrigation/ saline rinses and sprays and whether they've improved your numbers at all? you've got to get those nasal passages clear and it would be a shame to go to the aggressive surgical procedures before you exhaust more conservative options.
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I use Nasonex nose sprays every night, which hardly help. As for the nasal irrigation, I just daren't try that. You're talking here to someone who daren't even put her head under water in the swimming pool LOL. As for choosing my own surgeon, I may yet be flying out to New York if my lotto nos come up tonight. Watch this space...... ha ha!
Mike said:Kath -- your situation is so complicated, i definitely feel for you. Compounding that is the UK system of not being able to "shop around" for a doctor like Dr. Park who specializes in treating sleep breathing disorders. I know that over there you are assigned the ENT at your local hospital, and that's sort of the end of the story if you can't afford to go beyond the publicly funded option.
I don't recall, but remind us of whether you've experimented with nasal irrigation/ saline rinses and sprays and whether they've improved your numbers at all? you've got to get those nasal passages clear and it would be a shame to go to the aggressive surgical procedures before you exhaust more conservative options.
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Permalink Reply by betty m on
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Hi, i would certainly not go for any surgery. I learned the hard way that none of this surgery works!!!!
I had UPPP in 2007 and 2 years later the apnea is back!!!!!!!
I'm now trying to use the c-pap all over again. I would never recommend anyone have surgery,you're left with scars,no throat in the back,a deformed,sunk in nose,voice changes and throat congestion all the time.
Sorry, but I wish someone had told me !!!!!!!!!!!!!!!!!!!
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Sorry to hear that Betty. Did you have any of the nose ops too? I'm not looking for a cure for apnea, only better results with CPAP due to the nasal congestion. I've decided to definitely leave the palate surgery alone though.
betty mills said:Hi, i would certainly not go for any surgery. I learned the hard way that none of this surgery works!!!!
I had UPPP in 2007 and 2 years later the apnea is back!!!!!!!
I'm now trying to use the c-pap all over again. I would never recommend anyone have surgery,you're left with scars,no throat in the back,a deformed,sunk in nose,voice changes and throat congestion all the time.
Sorry, but I wish someone had told me !!!!!!!!!!!!!!!!!!!
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Permalink Reply by Banyon on
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Mary Z said:Kath, so sorry your surgery was not a success. And I thank Dr. Park for his response about the further surgery.
The Oracle by Fisher and Paykel is a mouth only mask, with nasal plugs, which you would not have to use. As I remember it comes with two sizes of mouthpieces. I tried one about a month ago, but had leakage around the nostril plugs and so could not use it. I found the mouthpiece to be very comfortable, though.
Mary, Why not tell Kath about that total face mask you use? After nasal surgery, it should be much better than the oral mask, don't you think?
Kath, I would find a surgeon that doesn't use the packing. My turbinate reduction surgery and septum correction was done without packing and things went very smoothly. The doc used splints for the septum which were removed on the third day post-op and I was back to normal except for avoiding heavy lifting for another week.
I would not have the palate surgery.
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i have never heard of any good coming from UPPP surgery. but i do know people who have benefited from nasal surgery -- septoplasty/ reduction of turbinates. so i want to make sure we don't lump all surgery together as being bad. i should say that the people i know who had good results went to surgeons specializing in sleep breathing disorders
betty mills said:Hi, i would certainly not go for any surgery. I learned the hard way that none of this surgery works!!!!
I had UPPP in 2007 and 2 years later the apnea is back!!!!!!!
I'm now trying to use the c-pap all over again. I would never recommend anyone have surgery,you're left with scars,no throat in the back,a deformed,sunk in nose,voice changes and throat congestion all the time.
Sorry, but I wish someone had told me !!!!!!!!!!!!!!!!!!!
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Thanks for the reminder Banyon about Mary's Total Mask. I think you're right about that being much better so shall try to locate one in time.
The surgeon was quite adamant that he'd need to put in packing, so goodness knows how I'll change his mind. The system here is different, so unless I come into money, I'm stuck with the surgeon I've got. Don't get me wrong, he's a lovely man, but no expert in sleep apnea.
Did you find a big improvement after your own nasal surgery?
Banyon said:
Mary Z said:Kath, so sorry your surgery was not a success. And I thank Dr. Park for his response about the further surgery.
The Oracle by Fisher and Paykel is a mouth only mask, with nasal plugs, which you would not have to use. As I remember it comes with two sizes of mouthpieces. I tried one about a month ago, but had leakage around the nostril plugs and so could not use it. I found the mouthpiece to be very comfortable, though.
Mary, Why not tell Kath about that total face mask you use? After nasal surgery, it should be much better than the oral mask, don't you think?
Kath, I would find a surgeon that doesn't use the packing. My turbinate reduction surgery and septum correction was done without packing and things went very smoothly. The doc used splints for the septum which were removed on the third day post-op and I was back to normal except for avoiding heavy lifting for another week.
I would not have the palate surgery.
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