The surgery included:
• Uvulopalatopharyngoplasty (UPPP)
• Tonsillectomy (typically considered part of UPPP)
• Adenoidectomy
• Hyoid Myotomy
• Genioglossus Advancement
She unfortunately experienced some unspecified complications stemming from this surgery which apparently has not helped with her obstructive sleep apnea either. A malpractice lawsuit commenced and final judgement is still pending.
Let's take a closer look at the incomplete information provided.
The patient suffered from mild-moderate obstructive sleep apnea which typically means a AHI score of around 15 (< 5 is normal).
For this level of severity, simultaneous multi-level surgery is not typically performed. Rather such extensive surgery is reserved for severe obstructive sleep apnea.
Also unclear is whether any objective studies were performed prior to surgery to try and localize the levels of obstruction that required correction. Such preoperative studies include a sedated endoscopy as well as trial of CPAP usage.
Assuming patient tried and failed to use CPAP and had objective evidence for multi-level obstruction, what did each of the surgical procedures do?
UPPP, tonsillectomy, adenoidectomy address mouth-level obstruction.
Hyoid myotomy and genioglossus advancement address tongue-level obstruction (the tongue can fall backward while sleeping causing obstruction).
Complications can occur for each of these procedures mainly dealing with bleeding, hematoma, infection, or abscess formation. Swallowing problems can also occur with the hyoid myotomy and genioglossus advancement.
Read more information on obstructive sleep apnea.
Source:
Sleep apnea surgery leads to malpractice lawsuit. Southeast Texas Record. 1/23/12
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