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Coblation Assisted Upper-Airway Procedures
#1
An ENT suggested this surgery to me for OSA. Anyone know about this?

I have been using cpap for about 10 months, and while I feel and think better, the sleepiness is still there. That's why I'm considering surgery. And the thought of not having to use cpap again is tempting.
Susilo
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#2
Surgery, including radical UPPP rarely eliminates the need for CPAP in individuals with moderate or severe OSA. I can sometimes reduce the pressure requirement, however results are not very predictable. Surgery is painful and can have complications making CPAP therapy less effective, so be very cautious in judging any claims. This study shows efficacy of full UPPP with tongue channeling achieves a median AHI that is still considered mild OSA https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3544378/ The problem here is at least half of the patients who only stared with mild OSA (10-36 AHI) still had 1.9-10.4 AHI after surgery.

I think you can see that improvement is possible, but eliminating the need for CPAP may be temporary or non-existent depending on the severity of your problem. With severe OSA (greater than 35 AHI), I would consider it unlikely you will be leaving behind CPAP, and could experience painful complications. The chances of improving your ENT's bank account are nearly 100%. Good luck with your decision.
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#3
Thanks. My AHI was 16 during the sleep study. Supine AHI was 29.3, lateral was 7.9(L), 0®.

I've read some threads regarding surgery, and conclude that UPPP is a no-no. But I can't find much info on Coblation Assisted Upper-Airway Procedures. Is it the same thing?
Susilo
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#4
Have you tried to google the subject?

I don't think they can guarantee that you will be able to stop using Cpap. If it we're me, unless I had a guarantee and could see statistics that show this to be successful as to being able to stop using Cpap, then I would not do it.
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#5
Yeah I did. What I found is mostly article about what it is, which I only partially understood. What I'm looking for is people's opinion and result, which I can't find. I dont think I'm gonna do it.
Susilo
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#6
Hi Susilo!  Many things besides sleep apnea can cause continued exhaustion.  If CPAP is controlling your apnea, then I would investigate alternative causes before considering surgery.  Adding vitamins D and A helped me but living in Jakarta, it seems very unlikely that you have a Vitamin D deficiency.  Low Thryroid, period limb movements, some medications, any many, many other things can affect sleep and sleep quality.
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#7
Using a hand mirror, open your mouth like a yawn and look in.
What do you see?

Now take a look at this article: https://en.wikipedia.org/wiki/Mallampati_score
How does what you see compare to the pictures?
                                                                                                                                                                                  
Please organize your SleeyHead screenshots like this.
I'm an epidemiologist, not a medical provider. 
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#8
(04-17-2017, 09:46 PM)chill Wrote: Hi Susilo!  Many things besides sleep apnea can cause continued exhaustion.  If CPAP is controlling your apnea, then I would investigate alternative causes before considering surgery.  Adding vitamins D and A helped me but living in Jakarta, it seems very unlikely that you have a Vitamin D deficiency.  Low Thryroid, period limb movements, some medications, any many, many other things can affect sleep and sleep quality.

Hey chill. I've been to several doctors and tested for thyroid, diabetes, copper, magnesium, vitamin d, lyme, b12, folic acid, but nothing so far. I only found that I have low testosterone, but the doc didn't indicate that it's the cause of sleepiness.

I remember you said that ideally the bottom pressure should be around 1.5-2 below 90% pressure. My 90% pressure used to be around 8, but now it's around 10. Should I increase my bottom pressure to something like 8?


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Susilo
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#9
I'm also not sure whether to use EPR 1 or 0. Both doesn't seem to get rid of the CA. I probably feel a bit more comfortable with EPR 1. Does it really matter?
Susilo
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#10
(04-17-2017, 10:15 PM)Beej Wrote: Using a hand mirror, open your mouth like a yawn and look in.
What do you see?

Now take a look at this article: https://en.wikipedia.org/wiki/Mallampati_score
How does what you see compare to the pictures?

It's class I if I yawn.
Susilo
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