As I am on a sabbatical leave now, thought of looking at the statistics of laser and Coblator surgery done for the last 2 and half years.
I used Co2 laser (G3 Laser) and Coblator (Arthrocare®)
A brief summary of the cases from Feb 2008- August 2008.
Total Number of Snoring and OSA patients -398
Total Number who under went laser surgery-342
Total number who underwent Coblator surgery-56
Total number of laser surgery for Snoring under LA-102
Total number of Laser surgery for OSA GA-242
Total number f Coblator surgery for Nasal blockage-7
Total number of Laser surgery for Allergic Rhintis LA-32
Total number of Laser surgery-Facial mole/Oral lesion-LA-21
Number of Redo Laser surgery for snoring and OSA-20
Surgery For Snoring and OSA
Consisted of several procedures like Septal correction, Turbinoplasty, Adenoidectomy, Tonsillectomy, Soft palate surgery-LAUP, CAUP, RF Somnoplasty,Tongue base reduction, Lateral pharyngoplasty and even Tracheostomy. There is no single tailor made procedure could cure the problem, each patient needed one or more procedures, to remove the obstruction.I have not done any Mandible surgery or Hyoid suspension surgery.Those patients were referred to the Maxillofacial surgeons.
Overall Result
70-80% improvement in OSA
80-90% improvement in Snoring
Complications:
Infection-Nil
Secondary bleeding-2 cases
Drynes of Throat common first 1-2 months in 20-30% patients
Nasal regurgitation-8 patients (only temporary lasted 2 months)
Voice changes-Nil
Reasons of failure:
Inadequate excision of tissue
Base of Tongue factor (BOT channeling using tried in 2 cases only)
Jaw factor-Retrognathia/micrognathia
Obesity
Mixed apnea-central component
Comment-
“In Obstructive Sleep Apnea=Remove the Obstruction”-is the logic
In snoring and OSA, surgery is treatment of choice, not CPAP. The causes of obstruction in the upper air passage have to be identified and corrected by surgery. Of course conservative management like loosing weight avoiding alcohol and other simple methods can be tried before going for surgery. Using CPAP is the last option which many patients find it very uncomfortable to use life time.
I hope more and more surgeons start doing surgery for this very complex problem and need more awareness is needed in medical and lay community about the advances in surgical treatment of snoring and sleep apnea.
