Surgery for Sleep Apnea

[ztraw]

I had my first appointment with an ENT specialist after being diagnosed with mild to moderate sleep apnea. The ENT gave me the option of having surgery to remove my Uvula (it is enlarged) and removing some nose cartlidge to help with my sleep apnea. She gave me a 70% chance that I could stop using cpap therapy for 5 to 10 years after the surgery. She also mentioned that having the uvula removed is very painful and will take about 2 weeks to recover. At this point I am not sure what I plan to do and would be interested to hear from anyone who has had this surgery and what the outcome was?

[sister]

Hi, I had the surgery,[uppp] in 2006, big mistake for me,only lasted 2 years and the apnea came back much worse than before.
I have a much harder time using the cpap now and it was the most painful experience I have ever had.
Sorry I can't be more encouraging but I really can't. Worse mistake I ever made!
Best of luck to you.

[Good-sleeper]

Ztraw;

Painful is putting it MILDLY I was told just about the same thing , remove the uvula and you "probably" won't need a cpap machine, well 8 weeks later, they were able to reduce the pressure from 10 cmH20 to 9, and I have been on my cpap machine ever since, that was 14 years ago.

When I had my surgery, they used a scalpel , they may use a laser now, recovery was quite painful I don't remember how many stitches I had in my mouth but it was a lot, and forget about eating ANYTHING solid for about 3-4 weeks ( hmmmm you know if you are overweight, this might be a good option ) really though, I was told the same as you and it did NOT help at all as far as I am concerned although I can do some cool party tricks like chug a beer really really fast!

If I had it to do over, NO I would not go through that kind of pain for 1 cmH20 and still be on cpap.

Good Luck Ztraw

[Cindy Lou Who]

ztraw,
A friend had the same surgery. I never saw a person suffer so much and live. It also changed how he talked, and it took months for him to relearn how to form normal sounding words that are formed in the back of the throat. I don't know if others had the same experience.
Right now I'm not in a good frame of mind to talk about Drs. All I can say... with lots of feeling...is Don't let them talk you into something just because they will benefit... not you!
Best wishes
Cindy

[jbn3boys]

I have not had the surgery, but my sleep doctor was just mentioning it the other day. She actually told me is does not have a very good success rate. She said maybe 50% (less than the 70% you were told). She said that when it does work, it is usually temporary. I just would have to ask myself if this very painful surgery was really worth it to get a few years (maybe) without cpap. I guess if you are having a really hard time with cpap, it might be worth it. But if you can adjust to cpap, then my gut feeling would be "why bother". I'm used to cpap now, so why not just keep using it, know what I mean?

[Thomas F.]

In my personal experience the success rate for surgery is directly tied to the Doctors expertise. In 2004 I had my tonsiles removed and a partial UPPP - basically removed 2/3 of my uvula. In 2005 I was using CPAP because the surgery obviously did not work. This ENT Dr advised me based on his experienence or lack of experience at that time. Since 2005 I have struggled to tolerate CPAP, tried dental devices, etc. etc. CPAP definitley helped me but I still had awakenings associated with the whole process of wearing a mask to sleep, stopping leaks,

Fast forward to October 2010: One last attempt at surgery!!!

I found a Doctor that is a genius when it comes to throat surgery for apnea. Based on my throat architecture he recommended:

1. Hyoid Advancement - get's the tongue out of the airway
2. UPPP - removed almost 1/2" inch of my pallet. UPPP is the tricky surgery that takes expertise and talent. There's about 15 different ways to do a UPPP with different incisions, folding skin, amount of flesh removed, etc based on what the Doctors experience indicates is the problem. The Doctor I went to has done 1000 procedures before me. Yes, I am happy to be number 1000 and not number 1. He did a lot of learning along the way which I am grateful for.

Pain: yes the UPPP is painful but less so than having my tonsiles removed. There was almost no pain associated with hyoid advancement. I had both procedures done in outpatient surgery and missed one week of work. The pain was worth the result for me.

I don't use CPAP anymore and am sleeping throught the night with 94-95% O2 levels on the oximeter.

[XSnorer]

Most interesting. I'm surprised by the high success percentages... Six years ago my ENT gave the UPPP probability of success at 5%. Needless to say, I did not go this route. Since that time, information like the above postings have kept me thinking that I made the right decision. So it has been a CPAP/APAP solution for me thus far.

[xenablue]

At my first appointment after SS with my neurologist, she mentioned that surgery was available if I wanted to consider it. I told her I didn't (had already read a lot here) and she said "good... the success rate is very low - you're better off learning to live with CPAP".

Good enough for me!

xena

[Megan]

I also had the surgery in august 2009, to be perfectly honest, I would rather have a baby a day for a month than go through that experience again - and it didn't help my apnoea. sorry I can't be more encouraging, but please do lots of research before you decided whether or not to go ahead and have the surgery. get a second opinion and even a third and fourth!
Good luck!

Megan

[SleepingUgly]

The ENT gave me the option of having surgery to remove my Uvula (it is enlarged) and removing some nose cartlidge to help with my sleep apnea. She gave me a 70% chance that I could stop using cpap therapy for 5 to 10 years after the surgery.

I would ask for the articles that support the statistics she's citing you. I haven't researched uvula surgery, as I was told off the bat never to let anyone touch it, but how much difference can the uvula alone make? I assume the nose cartilage issue is not removing the cartilage, but straightening it, as in septoplasty?

[Sharon1225]

The surgery didn't get me any time off my cpac.

[BrianR4743]

Run away..... as fast as you can. UPPP surgery was the most painful experience I've ever had, and was not one bit successful. I'd keep and eye on the tongue nerve stimulator that is currently undergoing clinical studies.

I miss my uvula.

[scrapper]

My brother had a similar experience as these writers............not positive at all, painful, and still on cpap years later.............. It will never happen here, unless something changes drastically in success rates

[rested gal]

Thomas F., I sincerely hope your results will last. Do hope you'll keep coming back here periodically to let us know how it's going for you. The additional (additional to UPPP) procedure to move the base of the tongue may make your recent combo-of-procedures surgery take care of things for a long time. Hope so. You're smart to continue monitoring your sleep with a pulse-oxi.

[Big Daddy RRT,RPSGT]

"Success" for this type of surgery is medicaly defined as a lowering of your AHI. In the sleep lab we see this kind of "success" all the time, unfortunately it means you may still need CPAP to treat your symptoms.

My experience has noted skinny people with something abnormally large in there upper airway and very mild OSA as having the most success. I have seen a couple of true (no CPAP needed) success stories in ten years. Mostly it is a disappointing mild reduction of the AHI for most patients ("success").

I have seen a few who were able to tolerate their CPAP better after upper airway surgery as they needed less pressure so this may also be counted as "success" for some patients.

Here at our lab we encourage our patients to try CPAP....you never know they might like it!