[T-2 yrs] Uvopalatal Flap, GA and yet another turbinectomy

After being scared to death about the recommendation of MMA from Dr. Li, I went to see Dr. Riley. He looked down by throat with a fiber and various other mouth and nose examinations. He also thoroughly went through my medical history. After all that, he recommended that I go through Stanford Phase 1 protocol.

Stanford Phase 1 protocol consists of uvopalatal lap where they trim the uvula and fold it back and sew it so that it does not create a rough edge. It also consists of GA (Genioglossus Advancement), tonsillectomy and adenoidectomy. I chose to believe him. After all I was nowhere psychologically prepared for an MMA. He told me that there was a 70% chance of success, he defined success of RDI less than 5.

We'll see if I am in the lucky 70% very soon. Monday morning is D-day. Signed off from work with some combo of sick leave and disability.

http://www.sleepsurgery.com/pdf/Sleep-Disordered-Breathign.PDF

One thing I wish I did was to met Riley or Powell a long time ago. Perhaps I would not have bothered with the dental appliance, he could straight away tell based on the fibre and X-ray.

Went out on the Internet and read all the Sleep Apnea blogs. Most of them are excellent but talk about MMA. I found one great blog about GA and UFP.

http://www.ski-epic.com/snoring/surgery.html

Brian was even kind enough to talk to me on the phone a few minutes ago. Fabolous guy, he is so glad to have gotten it done. Hope it works out for me as well as it did for him. I took my chances with Phase 1. The surgery itself was well done. Dr. Riley was particularly aggressive, he took a deep cut of my uvula, took out all my other soft tissue and did the GA as well. It was a horrendously painful recovery. It took me all of 6 weeks to get back to work.

After about 3 months, I went for a repeat sleep study. RDI had increased from 25 to 31! Right after my surgery, I felt great for about a month. Looking at the x-rays right after surgery, I noticed that my airway had increased from 5 mm to 8 mm at its narrowest. Three months into it, it looked like the tissues had relaxed and it was back down to 5 mm again.

I was so disappointed!

After that I discovered SleepNet, probably the most informative place on the web. An informal survey on sleep net patients who had soft tissue surgery alone showed that not more than 30% patients benefited from it. Also the general consensus is that uvula does not contribute to sleep apnea. If only I had known this, I would have never gone for soft tissue surgery.

To top it all during all the phase 1 x-rays, he found benign cyst under my wisdom tooth. Joy! He warned that if it was not removed, it might grow and eventually crack the jaw. Three months later I had follow up surgery and he took out the cyst. At the same time, he did RF on the back of my tongue (which I did not feel a thing).

At the end of all this, I was pretty much back to my crappy old self minus my soft tissue and several thousand dollars lighter. I now knew the pain of full anaesthetic surgery and recovery in a shared hospital room! BTW, the turbinectomy was a failure as well. My turbinates were swollen once again and I was snoring again as well!