Sleep Disorder

During normal breathing, air passes through the throat on its way to the  lungs. The air travels past the soft palate, uvula, tonsils, and tongue. When a  person is awake, the muscles in the back of the throat tighten to hold these  structures in place preventing them from collapsing and/or vibrating in the  airway. During sleep, the uvula and soft palate frequently vibrate causing the  distinctive sounds of snoring.

The LAUP procedure is a laser surgical procedure designed to sequentially  trim and shorten these structures, thus preventing or reducing snoring.

Risks and ComplicationsYou have the right to be informed that the surgery may involve risks of  unsuccessful results, complications, or injury from both known and unforeseen  causes. Because individuals vary in their tissue circulation and healing  processes, as well as anesthetic reactions, ultimately there can be no guarantee  made as to the results or potential complications. The following complications  have been reported in the medical literature. This list is not meant to be  inclusive of every possible complication. They are listed here for your  information only, not to frighten you, but to make you aware and more  knowledgeable concerning this surgical procedure.

1. Failure to resolve the snoring. Most  surgeons feel that about 85% of patients who undergo a LAUP will have a  significant or complete resolution in their snoring; and an additional  percentage of patients will notice reduced levels of snoring such that their  sleep partners will report that it's level is no longer offensive.

2. Failure to cure sleep apnea or other  pathological sleep disorders. Pathological sleep disorders, like sleep apnea,  are medical problems which may have associated serious complications. At this  time, the LAUP procedure has not been proven to cure these disorders.

3. Bleeding. In very rare situations, a need  for blood products or a blood transfusion. You have the right, should you  choose, to have autologous or designated donor directed blood pre-arranged. You  are encouraged to consult with your doctor if you are interested.

4. Nasal regurgitation, a change in voice, or  velopharyngeal insufficiency when liquids may flow into the nasal cavity during  swallowing (rare).

5. Failure to resolve coexisting sinus, tonsil,  or nasal problems.

6. Need for revision, or further and more  aggressive surgery.

7. Prolonged pain, impaired healing, and the  need for hospitalization

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Obstructive Sleep Apnea & Tonsils

Obstructive sleep apnea in normal children is almost always caused by  enlarged (hypertrophic) tonsils and adenoids). These children will display the  typical sleeping patterns of sleep apnea. They have loud snoring, frequent  pauses with breathing at night, frequent awakening from sleep, restless sleep,  nightmares, and bedwetting (enuresis). During the daytime, these children are  mouth breathers, may have excessive daytime sleepiness, and poor school  performance.

Other more rare causes of sleep apnea include any congenital (present from  birth) or acquired cause of upper airway obstruction.

The treatment of obstructive sleep apnea is directed to the cause of the  obstruction.

As noted above, most cases of obstructive sleep apnea in children is caused  by enlarged tonsils and adenoids. Surgical interventions are therefore directed  to what is causing the obstruction. In the case of enlarged tonsils and  adenoids, tonsillectomy and adenoidectomy is usually successful in relieving the  problem. If the problem is not the tonsils and adenoids, the cause of the  obstruction must be determined. For example, surgery of the jaw may be required.  In some cases, even a tracheostomy is necessary. Non-surgical therapies include  oral prostheses (difficult in children), medications (steroids, stimulants), and  weight reduction.

In almost every case of obstructive sleep apnea in children who do not have  unusual anatomic problems, tonsillectomy and adenoidectomy is a safe and  effective treatment, and is highly recommended.

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