Swan LogoRepose Tongue Stabilization Information

For the more complex patient with multilevel obstructive sleep apnea syndrome with significant obstruction present in the retrolingual and hypopharyngeal areas, the recent introduction of the Repose Tongue Stabilization System has dramatically improved upon our surgical success rate. As with the classic UPPP procedure, if performed alone it is successful approximately 40% to 50% of the time; however, when combined with palatal and/or nasal procedures, this minimally invasive base of the tongue procedure has increased our overall success rate to approximately 75%. Although 75% is far from perfect, it represents a major leap forward in our ability to eliminate base of the tongue airway obstruction. This procedure is performed under general anesthesia in a hospital setting.

Repose Tongue Stabilization System

Initially a hammock support comprised of a small titanium screw is introduced into the front part (medial aspect) of the jaw beneath the floor of the mouth with two attached nylon sutures, which are then passed through the mobile tongue and tongue base in a triangular fashion. Once introduced, the sutures are secured anteriorly after advancing the tongue minimally. Once complete the suture system helps prevent the prolapse of the tongue posteriorly, when the patient lies on his/her back at night. It is best to conceptualize this procedure as one that helps to prevent the tongue from falling backwards down the throat at night and obstructing the airway. This procedure represents one of the most exciting and yet simplistic procedures yet developed to treat obstructive sleep apnea.

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The procedures briefly explained thus far, are by no means all of the procedures available to treat obstructive sleep apnea syndrome or snoring. However, they do represent the most widely accepted and also the ones that had been clinically shown to yield the highest success rate with the least amount of surgical invasiveness. Obviously, if you tracheotomize a patient (put a hole in the patient's wind pipe), you cure virtually all OSAS patients. However, most patients do not wish to live with a hole in their neck anymore than being hooked up to a CPAP (life support machine) for life. Although CPAP is effective in correcting snoring and obstructive sleep apnea syndrome almost 100% of the time, Kribbs, et al, reported that only 6% of patients wear the CPAP 7 hours per night 70% of the nights. Most authors report an overall 50% to 70% compliance (effective usage) with the CPAP units. In other words, the compliance rate for patients attached to a CPAP machine is quite low and far from ideal. Another procedure that still falls within the so-called Phase I surgical protocol for the treatment of Obstructive Sleep Apnea Syndrome is the Hyoid Suspension.

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To view the slide show
Diagnosis and Treatment of Snoring and Sleep Apnea
, click HERE

For information about the Pillar Palatal Implant System, click HERE

For information about our Sleep Laboratory , click HERE

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HEAD & NECK SPECIALTY GROUP OF NEW HAMPSHIRE
361 High Street Somersworth, NH 03878
John M. O'Day, M.D., F.A.C.S. Marjorie K. Stock, M.D. ,F.A.C.S.
William E. Long, Hearing Instrument Specialist
Telephone: 603-692-4500 Fax: 603-692-4520
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