UPPP, Septoplasty & Turbinate Reduction

[meguys123]

Hey All,

Been battling sleep apnea for years now. I also have bad nasal congestion which is much worse at night time- unfortunately the only spray that works is Afrin (I only take a little at night, not during the day since I need it to breathe through my nose at night).

I have tried CPAP but I failed with it- I am currently wearing an Oral Appliance to sleep- the Tap 3 Elite. While the Tap 3 Elite helps, my sleep studies show that I still have RERA arousals- it is better than apneas but it isn't curing the problem or controlling it enough.

I saw an ENT doctor that specializes in Sleep (he is the Head of Sleep Disorders)- he recommended performing Septoplasty, Turbinate Reduction and UPPP with laser (without removing the tonsils, only shrinking them via Laser). He said the Septoplasty and Turbinate reduction would help with the nasal congestion since my passages are very narrow due to deviated septum and enlarged turbinates. But the apneas were likely coming from my throat and I am a perfect candidate for UPPP based on my anatomy (I am medium weight).

Any thoughts? The Doctor said that they've come a long way with surgeries and the recovery would only be around 4 days. He said it wouldn't be too painful because he wouldnt be taking away too much tissue

[zonk]

Septoplasty and turbinate reduction may helps
UPPP is no no ... at least for now

Failed CPAP is not an answer, there are solutions for every problem
Have you tried full face mask?
With this type of mask, you can breathe through your mouth without compromising the treatment

I had both septoplasty and turbinate reduction, helps a lots with nasal breathing
When my nose feel congested, I use saline nasal rinse and increase humidification
Humidity setting is personal, some like more or less than others, everyone is different

[trish6hundred]

Hi meguys123,
WELCOME! to the forum.!
I'm sorry you have had so much trouble with CPAP therapy. I've heard those surgeries are quite risky.
Hang in there for more answers to your questions, much success to you.

[49er]

Hi meguys,

I am sorry you have had so many difficulties with treatment.

I am not anti surgery but I would make darned sure you have tried everything. Perhaps you want to list what you have tried to make sure nothing has been missed such as various pressures, masks, machine, etc.

If you honestly feel you have tried everything and feel that surgery is your best option, then here are the issues you need to cover in a discussion with your ENT regarding the UPP procedure. On what basis did he claim the problems were coming from your throat? Was an extensive examination done of your airway such as a naso endoscopy or a sleep endoscopy? The reason I am asking is many surgeons just take a cursory look and pronounce what the problem is based on that quick exam and then operate. And then everyone wonders why the failure rate is so high.

I would also visit also google Dr. Steven Park and download the document about considering sleep apnea surgery. I think it would be considered a commercial site so I am not providing the link to it.

I would also go to these excellent sites on sleep apnea surgery for some excellent information that will give some ideas as to questions to ask your surgeon.

<Link removed> Google "sleep apnea surgery center" to find it

For any sleep apnea surgical procedure, you should always ask your surgeon what percentage of his/her patients end up having an AHI of below 5 and for how long do these results last. And of course, ask the other typical questions about surgery such as benefits vs. risks.

Regarding the septoplasty, that will improve your nasal optimization but won't cure your apnea although it may reduce the severity level.

Best of luck.

49er

Hey All,

Been battling sleep apnea for years now. I also have bad nasal congestion which is much worse at night time- unfortunately the only spray that works is Afrin (I only take a little at night, not during the day since I need it to breathe through my nose at night).

I have tried CPAP but I failed with it- I am currently wearing an Oral Appliance to sleep- the Tap 3 Elite. While the Tap 3 Elite helps, my sleep studies show that I still have RERA arousals- it is better than apneas but it isn't curing the problem or controlling it enough.

I saw an ENT doctor that specializes in Sleep (he is the Head of Sleep Disorders)- he recommended performing Septoplasty, Turbinate Reduction and UPPP with laser (without removing the tonsils, only shrinking them via Laser). He said the Septoplasty and Turbinate reduction would help with the nasal congestion since my passages are very narrow due to deviated septum and enlarged turbinates. But the apneas were likely coming from my throat and I am a perfect candidate for UPPP based on my anatomy (I am medium weight).

Any thoughts? The Doctor said that they've come a long way with surgeries and the recovery would only be around 4 days. He said it wouldn't be too painful because he wouldnt be taking away too much tissue

-----
Moderator Action: Link Removed

To maintain our status as an educational organization, the only commercial links allowed in this forum are to CPAP-related manufacturer websites. This is stated in the Apnea Board Rules with details given in the Commercial Links Policy section.

-----

[me50]

Most that have UPP surgery still require the machine. I have read that it is extremely painful, recovery is long, there are issues with eating even after recovery just to name a few. Google patient reviews rather than take the word of someone who hasnt had the surgery. Most of the time the only person to come out ahead is the surgeon.

[Ghost1958]

Just had most of tht and polyp removal.
You will still need the machine. Try more like 4 eeeks for partial recovery.
Lot of pain, lot of bleeding.

[meguys123]

Thanks for all the feedback everyone.

The Doctor performed a Diagnostic Laryngoscopy.

Below is my history over the past few years:

1)Did a sleep study that determined I had mild-moderate sleep apnea. The Doctor prescribed a CPAP- I used for a while but had trouble getting used to it.

2)Did another sleep study with CPAP- Doctor determined I should do pressure of 10. Study found that I also had many "spontaneous arousals and alpha intrusion"

3) I tried the CPAP for a while but I wasn't feeling better. I saw a Dentist that specializes in Sleep who said I would be perfect candidate for the OSA Appliances since my apnea is mild-moderate. I paid out of pocket for the Silent Nite appliance.

-Did a sleep study with the SN appliance and the study showed that it wasn't improving my AHI by much. My Doctor convinced me to get the Tap 3 Elite since they said it was the best one in the market.

-Saw supposedly the best Sleep Doctor in NY who ordered a sleep study- 1/2 with the Tap 3 Elite and 1/2 with CPAP. I failed with CPAP and was better with Appliance but not by so much. I also had alpha intrusion and spontaneous arousals.

-I advanced my Tap 3 elite as much as I could without hurting myself too much and did an at home study. I still failed.

I know the appliance helps somewhat because when I don't wear it, I feel myself gasping much more. Also- I have apneas without it- with it, I have RERAS's (Respiratory effort related apneas) which are less severe I guess.

Anyways, I am exhausted and I am sure reading my post was exhausting! So I am ready to try the surgery in the hopes it will fix my issues. If it doesn't, hopefully the Nasal part of the surgery will help me enough where my appliance would work.

[49er]

meguys,

What did the doctor say about your uvula needing to be operated on based on the results of the laryngoscopy? What did he/she say your chance of getting the AHI to 5 or below based on his/her experience with previous patients and for how long would this last?

To be honest, as one who wonders if surgery is in my future, the UPPP is about the only procedure I would not consider. It seems to me the risks outweigh the benefits big time.

I definitely understand your desperation but when you feel that way, it is a warning to take a step back and carefully make sure you are doing the right thing. I am not trying to talk you out of surgery but why this procedure vs another one?

You also might want to consider just doing the septoplasty/turbinate reduction which is the approach I took since this had the least amount of risks.. While it definitely optimized my nasal breathing, I haven't yet seen results with my pap therapy issues so I am looking at several things..

But this might be the ticket for you and would certainly entail less risk. If it doesn't work, then you can look into other procedures

Thanks for all the feedback everyone.

The Doctor performed a Diagnostic Laryngoscopy.

Below is my history over the past few years:

1)Did a sleep study that determined I had mild-moderate sleep apnea. The Doctor prescribed a CPAP- I used for a while but had trouble getting used to it.

2)Did another sleep study with CPAP- Doctor determined I should do pressure of 10. Study found that I also had many "spontaneous arousals and alpha intrusion"

3) I tried the CPAP for a while but I wasn't feeling better. I saw a Dentist that specializes in Sleep who said I would be perfect candidate for the OSA Appliances since my apnea is mild-moderate. I paid out of pocket for the Silent Nite appliance.

-Did a sleep study with the SN appliance and the study showed that it wasn't improving my AHI by much. My Doctor convinced me to get the Tap 3 Elite since they said it was the best one in the market.

-Saw supposedly the best Sleep Doctor in NY who ordered a sleep study- 1/2 with the Tap 3 Elite and 1/2 with CPAP. I failed with CPAP and was better with Appliance but not by so much. I also had alpha intrusion and spontaneous arousals.

-I advanced my Tap 3 elite as much as I could without hurting myself too much and did an at home study. I still failed.

I know the appliance helps somewhat because when I don't wear it, I feel myself gasping much more. Also- I have apneas without it- with it, I have RERAS's (Respiratory effort related apneas) which are less severe I guess.

Anyways, I am exhausted and I am sure reading my post was exhausting! So I am ready to try the surgery in the hopes it will fix my issues. If it doesn't, hopefully the Nasal part of the surgery will help me enough where my appliance would work.

[Happiest]

As 49er says, I'm not anti-surgery, but i would make darned sure you've tried everything.
I had a turbinate reduction 20 years ago, and it did nothing.
I had the laser LAUP 15 years ago and found that after several months of healing (during which my apnea was significantly worse) it helped somewhat. The LAUP is done in stages, and I had it done twice. I could have had a 3rd LAUP at no cost, but it was already getting hard for my food/drink to go down, and not up into my nose.
Under NO CIRCUMSTANCES would I have a standard UPPP.

I've been lurking on this board since my dental appliance is losing its effectiveness, but I joined just so that I could warn you to be careful!

[meguys123]

Thanks for all the feedback everyone.

I had the procedure done 8 days ago. The 1st few days were painful but I got through it.

Right now I still have a sore throat and I am still congested because the inside of my nose is still swollen. Too early to tell if this solved the problem but my wife says that I now breathe heavy during sleep instead of snoring- and that is while I can't really breathe through my nose yet.

I'll keep you posted