Obstructive sleep apnea surgery is one of the most controversial subjects in sleep medicine. You will find heated debates in the sleep community along with online forums and support groups. Apnea surgical treatment is not at all for all, for quite a few, it could be a life-changing experience.
Listed here are 5 important circumstances that you should be aware before considering any type of obstructive sleep apnea surgery:
1. Does obstructive sleep apnea surgery work?
Yes, only when done efficiently. Similar to with CPAP or dental devices, should you don’t apply it properly or put it to use in any way, it won’t work.
Just about the most common misconceptions about sleep apnea surgery the relatively low effectiveness of your uvulopalatopharyngoplasty (UPPP) procedure, which is often quoted at 40%. But performing this operation is similar to bypassing just one blocked heart vessel when you have 3 other vessels that are blocked. For some strange reason, ENTs are overly obsessive about the soft palate, as this is where snoring usually arises from and that we hold the most research and procedures for that soft palate.
We now are aware that in the event you address the complete upper airway together (nose, soft palate, tongue), then the success rates are far better, approaching 80%. Why only 80%? There’s only a lot you can do along with the soft tissues within the small space within smaller jaws (the main anatomic grounds for sleep apnea). The greater amount of aggressive you are, the better the success rate, however the more probability of pain and complications.
When you go to a higher level and enlarge your jaws (lower and upper), then success rates can reach 90 to 95%.
To set things into perspective, in case you bypassed everything having a tracheotomy (putting a breathing tube below your voice box), then you’ll have got a 100% «cure», but obviously, this is not a very practical option.
One question you should ask then, is, what’s the meaning of success? In surgery, one common definition is usually that the final AHI (apnea hypopnea index) using a formal sleep study drops bigger than 50% in the original and the final number needs to be fewer than 20. One of the primary criticisms of apnea surgery is that regardless of whether «successful», you might continue to have mild apnea. Surgeons will argue that it’s superior to not using CPAP at all.
2. Its Not All Surgeries Are Identical
You can find probably lots of procedures for sleep apnea from various nasal, soft palate and tongue operations to skeletal framework procedures. These can consist of minimally invasive to major surgery. The problem is that by definition, they’ll all work to a specific degree. For instance, procedures for the stuffy nose have been shown to «cure» sleep apnea in 10% of patients. But for the most part, none of the options themselves have very good success rates.
The secret is to check top of the airway for each and every individual and figure out the place that the obstruction is and deal with it simultaneously. Most people many section of obstruction. Surgeons at Stanford have in regards to a 75 to 80% success rate with soft palate and tongue base procedures. This is called multi-level surgery for apnea. You must check out the airway from your tip from the nose all the way to the voice box.