i have savere osa 120 per hour without bi pap 40 per hour with bipap o2 levals at 88% on bipap 67% off bipap i have had uppp 3 times radio frequency to shink the tongue, a cable throught my tongue to pull my tongue forward air way at tongue base is 8-10mm during waking hour im concidering a trach any thoughts
Person's Gender: Male
Person's Age: 44
Do you have any associated condition like COPD/Empysema , Hypertension,Thyroid disorder or any other systemic disease along with the OSA?Are you on any medication for any other disease?Are you a smoker and are you overweight?Please give me more information.Thanks.
i am 5' 10" 250 i have been down to 175 the apnea stays the same it is the base of
my tongue that is the problem my airway is very narrow i do have high blood presure
The hypertension could be secondary to the OSA and obesity.Surgical techniques like UvoluPhayngeoPalatoPlasty(UPPP)and Tongue Base Reduction and Hypoepiglottoplasty(TBRH)have been found useful in some patients with severe OSA.More aggressive surgery like UPPP with GenioGlossal advancement/maxillomandibular advancement/hyoid advancement/hyoidthyroidprexia and pillar procedure may be needed in some patients.Use of a autotitrating C-PAP machine(This is considered superior to a BiPAP device if it can be tolerated) with nasal mask/ connections and supplementation of oxygen may help reduce the hypoxic events.Lifestyle modifications include reducing weight,good sleep hygiene,abstaining from alcohol and tobacco,ruling out diabetes and thyroid disease would help.,A evaluation by a Sleep Specialist to look for anatomical problems and their correction will be the best.A tracheostomy would be the last step as associated morbidity and psychosocial problems make it a infrequently used method.Vakul Aren41042.7436422454
i have done most everything except the pillar procedure not sure what that is
The pillar procedure involves placing implants in the soft palate,leading to subsequent hardening of the soft palate.http://www.mayoclinic.com/health/pillar-procedure/MY00516 and http://www.medtronic.com/for-healthcare-professionals/products-therapies/ear-nose-throat/sleep-disordered-breathing-products/pillar-p are sites of interest.Perhaps losing weight and staying there would really help if all else fails.
i have had the uppp three times there is nothing left the jaw foeward procedure and
or a trach are the only other options im aware of
The tracheostomy should be contemplated only as a last ditch effort.I would suggest losing weight,regular exercise and using a self titrating C-PAP for some time be given a fair trial.The mandibular advancement may also be considered before a tracheostomy.
MBBS,DTM&H,30 years of experience