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Tongue shrinking surgery o ers sleep
BY KYLA GOODFELLOW
A cutting edge treatment for patients with obstructive sleep apnoea, involving shrinking the tongue and reshaping the palate, is
being put to the test in a new study led by the Adelaide Institute for Sleep Health (AISH) at the Repatriation General Hospital (RGH).
The new surgical technique, pioneered by former
Flinders Medical Centre (FMC) surgeon the late Dr
Sam Robinson, offers a potential cure to patients
who fail to benefit from existing remedies,
including Continuous Positive Airway Pressure
(CPAP) therapy -- currently the gold standard
The study follows a pilot last year, which saw the
technique trialled on 48 patients at FMC and the
Illawarra ENT Head and Neck Clinic in NSW. As
reported by Southern Health News in April 2013,
the treatment cured 70 per cent of the patients.
The new study will involve about 100 patients
and marks the next phase in the Institute's work
to make the surgery available to patients as an
additional therapeutic option.
The new procedure, co-designed by FMC Surgeon
Dr Eng Ooi and Flinders University Professor
Simon Carney, combines several existing surgical
techniques which -- when carried out in isolation
-- offer limited relief.
Project Lead and AISH Clinical Director, Associate
Professor Nick Antic, is hopeful that combining
the techniques into a contemporary multi-level
surgical approach will offer much greater success.
In an effort to control the condition, many people
spend long nights hooked up to a mechanical
breathing device (a CPAP machine) or wear
bulky dental plates -- known as a Mandibular
Advancement Splint (MAS) -- to move the lower
Unfortunately, for up to 50 per cent of the
estimated one million Australians who suffer
from the condition, they cannot tolerate CPAP
therapy which forces air into their lungs, while
MAS therapy is limited by cost, tolerance and
sometimes clinical effectiveness.
"Sleep apnoea is placing a big burden on the
nation's public health system," Assoc Prof Antic said.
"The problem we have is there are so many
patients with the disease and the main treatment
is CPAP...but it's only tolerated by about 50 to 70
per cent of patients so there is this big number of
people who can't use it and need other therapies.
"Having surgical techniques to help those patients
The new procedure, to be applied to patients
in Adelaide and Wollongong, NSW, combines
an advanced version of an existing surgery to
remove the tonsils and reconstruct the soft palate
(uvulopharyngopalatoplasty, UPPP) with a less
invasive operation to shrink the tongue (coblation
channelling of the tongue, CCT).
In March this year, AISH was awarded a $630,000
National Health and Medical Research Council)
project grant to further explore the new technique.
Preliminary data surrounding the new procedure
was presented at the American Thoracic Society
Meeting in Philadelphia in 2013 where it was
agreed that a more detailed study, if resulting in
positive outcomes, could change clinical practice
around the world.
Dr Ooi said early data suggested the technique,
which incorporates the "exciting new technology
of being able to remove, or reduce, tongue tissue
safely", could improve quality of life for many
more patients by reducing collapse of the tongue
and throat tissues.
People aged between 18 and 70 who have
moderate to severe sleep apnoea and have failed
to tolerate or benefit from CPAP and MAS could
be eligible to take part in the trial.
The study involves physicians and surgeons from
RGH, FMC, Flinders Private Hospital, Memorial
Hospital, Royal Adelaide Hospital, Wollongong
Hospital and Figtree Private Hospital, Illawarra
ENT Head and Neck Clinic, and the University of
Washington in Seattle.
To discuss your eligibility, contact Research
Manager Alison Pinczel on 8275 1022 or
FMC Head and Neck Surgeon Eng Ooi and
Flinders University Professor Simon Carney
co-designed a new surgical procedure for
patients with obstructive sleep apnoea.
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