Volume 1, Issue 2

Page 7

Surgery, by its very nature, is a very serious and dangerous option. With the exception of a Tracheostomy there is no real proven surgical option. Anybody considering surgery should discuss it firstly with their Sleep Specialist (not a surgeon).
Tracheostomy: Involves cutting a hole in the throat, inserting a plastic or metal pipe which is 'corked off' during the day. It is reckoned to be 100% successful in the treatment of Sleep Apnoea. Drawbacks include hygiene problems leading to possible infection and the actual appearance of the site of surgery (stoma). On the plus side it is completely reversible.

Uvulopalatopharyngoplasty (also known as UPPP or UP3): Involves removal of the soft palate, cutting back the uvula and removal of other loose tissue. If tonsils and adenoids are present they may also be removed along with this procedure, as can sections from the base of the tongue, if considered too large. The idea is to remove any possible sites of obstruction to enlarge or free the airway. The surgery is painful and there can be an immediate improvement after the post operative swelling diminishes, however this seems to last for up to six months maximum. Best statistical estimates are a possible 50% improvement in 50% of cases, which indicates that in all but the most mild Sleep Apnoea, CPAP would still be required after the surgery. There are no reliable statistics for cases which are over 18 months old. This form of surgery is seldom undertaken now.

Laser Assisted Uvulopalatopharyngoplasty (also known as LAUP): Similar procedure to the UPPP, however a laser is used instead of a scalpel. It is usually completed over a number of treatments. Results are similar to the UPPP.
There are a number of variations on this type of surgery (UPPP and LAUP), however there are no detailed statistics indicating any major improvement in the outcome.

Maxillo Mandibular Advancement: This involves the breaking of the jaw, reshaping the structure of the face (brought forward), rewiring the jaw and waiting for it to set. Pretty serious surgery with no guarantees. Major pain factor plus eating through a straw for a while. There is also a danger of infection and possible orthodontic work to follow.
There are no reliable statistics available for this procedure. Sometimes the procedure is carried out in conjunction with other procedures such as the UPPP or variation.
Surgical 'cures' appear to be most popular in the USA, and it is from there that most statistics are compiled. Latest indicators are that patients opting for the 'surgical' route in the USA are being offered a 'cocktail' of surgical procedures over a period of up to 2/3 years. Statistics for these are unreliable.

" Worried about insurance issues"

We will accept most formats. If handwriting, make sure that it's legible. We would of course prefer a nicely typed documents of anywhere up to 1,000 words (max), for example we can squeeze approx 400/450 words into each page.
Some guidelines: If you have Microsoft Word or Lotus Notes:
Normal type, font size 10/11 or 12.
Email to
If you prefer post, then send it to Newsletter, ISAT, PO Box 8440, Dublin 24.
MOST IMPORTANT: WE NEED YOUR PHONE
NUMBER.

Quite a lot of members have expressed concern  under this heading.
This whole area is being investigated by a sub committee of ISAT and we expect to have some results in the not too distant future.
Regrettably it is an issue which will be ongoing for some time, however it is having  attention and your  patience is appreciated.
We expect to include an interim report of our progress in the next issue of Snooze Nooze.