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Anybody had surgery for OSA?
#1
Just curious if anybody had any surgery(s) for OSA and would like to share their story here
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#2
Hi someboy,
WELCOME! to the forum.!
I haven't had any surgery for OSA and I've heard those surgerys can be quite painful, and in most cases after surgery, people have had to use CPAP therapy even though they have had surgery. Hang in there for more answers to your question.
trish6hundred
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#3
I had jaw surgery, both my jaws were advanced several millimeters. It was pretty painful and did not help my sleep apnea. I don't think it's a good idea unless you are a very obvious surgical case (in my case I had a severe underbite that required surgery to correct anyway). Make sure to get a surgeon who knows what they're doing, if not done properly it can actually reduce the airway and make apnea worse.
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#4
My pressure runs high (in the high 18s to mid 19s all night, bumping up against 20) and since I'm only 41, I figure my apnea will get worse as I age - making a bi-level machine necessary at some point. My apnea isn't weight related, so losing weight isn't the answer. I always assumed my jaw structure to be the issue - deep bite was corrected by an orthodontist when I was a teen by moving the teeth, but not the jaw (deep bite and severe OSA run on my mother's side of the family); so I was considering mandibular advancement surgery as an option...not as a cure, but just to keep my pressure needs under control. Before really checking out the surgery though, I figured a mandibular advancement device should help out, so I tried a couple different brands out - they didn't help at all. I had them adjusted out as far as they would go and my jaw was pulled several millimeters forward - had to wear a chinstrap to keep my mouth shut and my teeth seated in the device properly (they were both "boil and bite" type devices). I was using them in conjunction with my APAP and they didn't lower AHI or make my pressures run lower AT ALL, all they did was make my teeth hurt.

Obviously, all consideration of having the surgery died on the vine.

Try a mandibular advancement oral appliance first, before any serious consideration of having the surgery.

There is no way I would even consider UP3, too many horror stories and hardly any successes.
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#5
First step in having surgery is NOT mandibular advancement. It is the UPPP (Uvulopalatopharyngoplasty). I had it in 2002...kept my apnea under control until I lost a lot of weight in 2011. And it wasn't the apnea that was my issue but the hypoxia. So I had a LeFort/SSRO (mandibular advancement of both jaws and it CURED my hypoxia.

I will say that there can be side effects to the jaw surgery (I had NO side effects to the UPPP except a 10 lb loss due to inability to eat solids for a week) so be aware of all complications. IF you go the mandibular route, make sure you see an Oral & Maxillofacial surgeon NOT a dentist. Oh and I didn't bother with the mandibular devices...just seemed like a temp fix.

Liz
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#6
You may wish to read this thread:

http://www.apneaboard.com/forums/Thread-...-denies-me

Specifically, ConnCarl's reply in post #3 of that thread, where he describes his experiences with UPPP surgery. Kind of scary to me.

Sad
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#7
(08-29-2013, 08:12 PM)southernlady Wrote: First step in having surgery is NOT mandibular advancement. It is the UPPP (Uvulopalatopharyngoplasty). I had it in 2002...kept my apnea under control until I lost a lot of weight in 2011. And it wasn't the apnea that was my issue but the hypoxia. So I had a LeFort/SSRO (mandibular advancement of both jaws and it CURED my hypoxia.

I will say that there can be side effects to the jaw surgery (I had NO side effects to the UPPP except a 10 lb loss due to inability to eat solids for a week) so be aware of all complications. IF you go the mandibular route, make sure you see an Oral & Maxillofacial surgeon NOT a dentist. Oh and I didn't bother with the mandibular devices...just seemed like a temp fix.

Liz

Liz, I'm assuming then that you still have apnea, only that your events are not long enough now to cause hypoxia and that you don't need to use the cpap anymore? Is this correct? And if you do still have apnea, I'm curious as to the length of your apneas now.

Also, I'm not sure what you mean by this:

"First step in having surgery is NOT mandibular advancement. It is the UPPP (Uvulopalatopharyngoplasty). "

Could you explain? I'm considering MMA and actually have an apptmt to discuss this option. My tongue is scalloped deeply all the way around from pressing against my teeth. It is entirely too big for my mouth due to bad orthodontia as a child. (I am not overweight.) On top of that, x-rays revealed an extremely small throat area. So my tongue falls back numerous times in the night and blocks my small airway, leading to extremely long apneas. At this point, I feel I have no option but to get the MMA. I've not had any surgeries thus far. BTW, the cpap is no problem for me. Only that it does not correct the tongue issue. Thanks for posting.
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#8
(08-30-2013, 04:14 AM)Elen Wrote: Liz, I'm assuming then that you still have apnea, only that your events are not long enough now to cause hypoxia and that you don't need to use the cpap anymore? Is this correct? And if you do still have apnea, I'm curious as to the length of your apneas now.

Also, I'm not sure what you mean by this:

"First step in having surgery is NOT mandibular advancement. It is the UPPP (Uvulopalatopharyngoplasty). "

Could you explain? I'm considering MMA and actually have an apptmt to discuss this option. My tongue is scalloped deeply all the way around from pressing against my teeth. It is entirely too big for my mouth due to bad orthodontia as a child. (I am not overweight.) On top of that, x-rays revealed an extremely small throat area. So my tongue falls back numerous times in the night and blocks my small airway, leading to extremely long apneas. At this point, I feel I have no option but to get the MMA. I've not had any surgeries thus far. BTW, the cpap is no problem for me. Only that it does not correct the tongue issue. Thanks for posting.
According to both my sleep doctor AND my oral surgeon, I NO longer have apnea. They consider me cured. Last time I tested, my events were less than 2 AHI. Cut off for sleep apnea is 5. I gave back my cpap after surgery as it was no longer needed and not paid for yet.

Having an excessively large tongue is one of the exceptions to the rules of having a UPPP first. Altho they will also typically do a UPPP at the same time.

My throat (airway) was also extremely small but my tongue wasn't an issue. By advancing the jaw, I was able to gain a significant increase in my airway and that was the root of my issues.

Good luck.

Liz

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#9
Liz,

You have TOTALLY made my day! I am going to discuss the UPPP because I really don't want to get rid of my uvula, since I understand it can be involved in taste and swallowing. I definitely want to get the skinny on that when I talk to the doc. I have read more than my share about that! Also, I know there's a possibility it might not be a complete panacea for me, as it is for you. I have a feeling I might always need the cpap, but if the throat opening is made big enough so that it cannot be blocked by my tongue--I will consider me a success! For some reason I have a feeling that all of my "air tubules" are small and prone to collapse--that's just a guess. I constantly imagine the day when I can just strap on the cpap, go to sleep, and not be anxious about viewing the sleep report to find out how horribly long each apnea lasted. Again, you are the Bomb!, southernlady.

(08-30-2013, 08:31 AM)southernlady Wrote:
(08-30-2013, 04:14 AM)Elen Wrote: Liz, I'm assuming then that you still have apnea, only that your events are not long enough now to cause hypoxia and that you don't need to use the cpap anymore? Is this correct? And if you do still have apnea, I'm curious as to the length of your apneas now.

Also, I'm not sure what you mean by this:

"First step in having surgery is NOT mandibular advancement. It is the UPPP (Uvulopalatopharyngoplasty). "

Could you explain? I'm considering MMA and actually have an apptmt to discuss this option. My tongue is scalloped deeply all the way around from pressing against my teeth. It is entirely too big for my mouth due to bad orthodontia as a child. (I am not overweight.) On top of that, x-rays revealed an extremely small throat area. So my tongue falls back numerous times in the night and blocks my small airway, leading to extremely long apneas. At this point, I feel I have no option but to get the MMA. I've not had any surgeries thus far. BTW, the cpap is no problem for me. Only that it does not correct the tongue issue. Thanks for posting.
According to both my sleep doctor AND my oral surgeon, I NO longer have apnea. They consider me cured. Last time I tested, my events were less than 2 AHI. Cut off for sleep apnea is 5. I gave back my cpap after surgery as it was no longer needed and not paid for yet.

Having an excessively large tongue is one of the exceptions to the rules of having a UPPP first. Altho they will also typically do a UPPP at the same time.

My throat (airway) was also extremely small but my tongue wasn't an issue. By advancing the jaw, I was able to gain a significant increase in my airway and that was the root of my issues.

Good luck.

Liz

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#10
Hello ! Thanks for sharing your story here guys !

I want to start by saying there is no first step for sleep apnea anymore, surgeons used to go in blind and taking out unnecessary tissues that might not even address the obstruction. I was seen by 3 of the US leading surgeons; Dr. Kezirian (former UCSF now USC) , Dr, Kasey Li (Palo Alto Clinic) , Dr. Robson Capasso (Chief of sleep surgery Stanford Hospital).

Have anybody ever heard of "Drug Induced Sleep Endoscopy"? So, it is a procedure artificially puts a person into sleep, then the surgeon will scope out the person's upper airway with a scope that will record the entire procedure and identifies where the obstruction(s) is.

I was treated mainly by Dr.Kezirian; whom is one of the leading doctors in the world for sleep surgery. Before seeing him, i was worried i had to go through the UPPP and i have actually seen dr. kasey Li about getting the MMA surgery. After being examined by Dr. kezirian, I was informed my Uvula is in fact not an obstruction and MMA is not recommended for me. We decided to go with the "Drug Induced Sleep endoscopy" to locate my obstructions, before deciding on any surgeries.

So, my obstructions were identified as mainly Nasal and some tongue base. I have had the following surgeries with Dr.Kezirian to fix my Obstructions:

1. Therapeutic Bone Fracture of the nose (to open up more space for better breathing)
2. Turbinate bone removal (both sides)
3. Adenoid removal
4. Turbinate reduction
5. 3x Tongue Radiofrequency Reduction

Surgeries I had before else where:
Fixed Deviated Septum
Tonsil removal
Turbinate reduction x3


Before the surgeries, I was so dependent on the CPAP, I would wake up feeling like i got hit by a hammer on my head if i am not using it. When i was using it, I do not feel refreshed. I have received some of these surgeries recently and was told it would take up to 6 months to reach a plateau. I am able to get off my CPAP, does not wake up with a headache anymore. But still some symptoms of slight dizziness and waking up feeling sleepy.

Overall, I still do not feel 100% as i had hoped, still somewhat frustrated. But, I do feel so much better compared to before. Maybe, I will be better compliance with CPAP now. I am really hoping to get another sleep test in the future to see where i am at. However, my surgeon does not recommend me on wasting money like that, as I am only 23 and a student. But, I do hope with the advancement of sleep surgery, We can all be Apnea free in the near future.

I would highly recommend you guys checking out his website, he has some very good information in there regarding surgery
Can find his website sleep-doctor by googling his name.
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