LAUP vs Pillar?

Sleepy Tom · Guest

Hi,

i am 29yo, don't smoke, not overweight and was recently dx with mild sleep apnea. My ENT told me that LAUP might be a good option for me. He believes my obtruction comes mainly from my palate. I asked him about Pillar but he has never done the procedure. Has anyone done the LAUP procedure? was it painfull, effective?
Thank you for your reply!
Tom

Guest · Posted: May 23 2005 Post subject:

Had the LAUP procedure done in three sessions. It is painful (one seriously sore throat) but eased with meds...pain lasts about 4-5 days while diminishing. Reduced the OSA but did not cure. Currently using Apap.
However, I have heard that LAUP may work for MILD apnea as your ENT suggests. If you choose to procede, hope you have success. Please keep us posted as we like to hear success stories.

MJL · Guest

I've not had either, but I'd go with the pillar first and see if it works. It is the lesser evil. It doesn't hurt as much, is reversible, and I think less expensive. Look for a doctor on the pillar implant web site.

justme2 · Guest

Have you thought of trying a pap first?

Sleepy Tom · Guest

Have you thought of trying a PAP first?
Answer: Ideally I would prefer finding a procedure that would allow me to sleep without a mask on my head. I don't think I will be able to get use to it. Plus I have only mild OSA, most likely due to palate which makes me a good candidate for surgery. However, I don't want to kill an ant with a hammer and therefore am not interested in radical surgery such as UPPP. LAUP appeats to be better option and pillar which is reversible.

I think I will go with the pillar. My ENT (based in Manhattan) told me that he was contacted in the past by the company that commercialize the pillar and that they propose to pay for the procedure for his first patient. The obvious problem is that I would be a guinea pig. What is reassuring is that my ENT has performed tons of UPPP procedures, which compared to pillar, are more complex.

I will keep the board updated.

justme2 · Guest

I understand your wanting to avoid a pap and maybe surgery is the answer for you. I just wanted to throw out all options.

What did your doctor consider mild apnea? I know I was severe when diagnosed with over 110 apneas per hour.

What made you see a doctor in the first place? EDS? Partner notice you stop breathing? or something else?

I wish you the best of luck and look forward to hearing how it goes.

Jpnasty95 · Joined: 08 May 2005 Posts: 72 Location: NJ

hey tom,

let me know if your doctor is willing to do more "guinea pigs". or tell me what he charges for the pillar. i'm in northern Nj and had 2 quotes. $1500 and $1800. i was scheduled last friday to get it done, but, i feel i'm paying too much (after reading some posts on here where the patients negoiated a better price)

thanks

Jpnasty95 · Joined: 08 May 2005 Posts: 72 Location: NJ

wow, i just called a DR. on restore's referral list and they quoted me $2500.

Sara · Guest

Could someone explain to me what a pillar is? Thanks.
I am new to all of this and I am also looking for an alternate treatment to CPAP.

Jpnasty95 · Joined: 08 May 2005 Posts: 72 Location: NJ

sleepy tom · Guest

[quote="Jpnasty95"]

Guest · Posted: May 25 2005 Post subject:

To All:
I've had the Pillar, it's a reasonably painless procedure though there can be problems. Another alternative which seems reasonable is a pallet somnoplasty. Given the fact that few Doctors do this procedure, if you have insurance there's little value in trying to find the best price, however if you are paying out of pocket you may find a Dr willing to give you a discount because few insurance companies pay the Dr the amount they bill them for the procedure. $1,500-$1800 is the standard price the insurance company will be billed but even if a Dr bills them $2,500, I doubt they clear more than $1,200-$1,400 which is why if you are paying privatley you should be able to get a lower price.

The Pillar did not cure my apnea or my snoring for that matter. However the pillar in combination with a nasal somnoplasty and dental appliance enabled me to get off CPAP.

I have my sleep study in a few weeks, but I've been off CPAP for two months now I feel better than I ever did with CPAP, so I'm certain the sleep study will confirm what I already know, I don't need CPAP anymore.

For the majority of people getting the Pillar, this procedure alone will not "cure" your apnea and enable you to get off CPAP.

With regard to the Pillar VS LAUP, much less pain, probably just as effective.
Rick

Sleepy Stoboy · Joined: 23 Jan 2005 Posts: 449

The way I like to think of it is "major", "minor".

Seems in most people that the rear of tongue obstruction is the major problem. Surgically, there aren't many great options there, unless you go for the very radical and very successful MMA surgery. The GA, hyoid and repose surgeries are very untested and anecdotally seem to have very mixed results. The somnoplasty of the tongue is still being advanced, and there is encouraging news that taking those RF treatments in the front center of the tongue base may lead to better outcomes. But that needs time to advance and be proven medically. Many of us have solved this "major" problem with a dental device.

The pallet seems to be a "minor" player for most of us. Some of us have addressed this with the Pillar Procedure, which stiffens that tissue. Far better than a UPPP in my humble opinion. Doctors make less money, and patients recover in a fraction of the time. So new that many doctors either don't understand it, know about it, or dismiss it. Some people with mild apnea may be "cured" by this procedure alone, but for most of us, since it only addresses the "minor" problem, it can't stand alone. I had the pillar implants done first, and although it cut my apnea in half (36 to 1 Cool

, it didn't cure it. Addressing the tongue base with a dental device did.

Most people start out with a hope that there is a "one and done" surgical procedure and when they investigate, usually find an ENT happy to do a UPPP, which has a very poor cure rate and some potentially lifetime side effects. These folks either try it and realize it doesn't cure them, or they walk away frustrated there aren't better alternatives.

If you check out the dental forum, you'll find a very viable combination treatment that several of us are trying with great success. It will require two visits, one to an ENT and one to a sleep dentist. It also requires a ramp up period to adjust your jaw to this device. But it is a remarkably simple, convenient way to resolve your apnea.

Jpnasty95 · Joined: 08 May 2005 Posts: 72 Location: NJ

is there a GA procedure that doesn't involve moving bones and inserting plates or screws. ie. taking the tendon/ligament and tightening. thus bringing the tongue foward?

Sleepy Stoboy · Joined: 23 Jan 2005 Posts: 449

No way that I know of to tighten the muscular structure without touching the bone that it's attached to. The repose technique uses a suture, but there is a screw attached.

Until other treatments emerge, you might try a dental device which brings the mandible forward without any permanent reconstruction. Some people have reported success with somnoplasty of the tongue. This will require 5-6 treatments and does run a risk of infection in a very small percentage of patients. These infections could be fatal if not treated quickly.