Greetings and thanks in advance for your help and consideration. It's amazing how these bulletin boards can help.

We just found out that Sam (9 yrs old) has sleep apnea. We were sent to a ENT by our pediatrician, who then referred us to a specialist at Stanford Med for a second opinion. The first ENT looked at tonsils and adenoids and didnt think they were bad. The Stanford doc used the camera through the nose trick and also didnt think things were too bad, but suggested the sleep study be performed at Stanford.

We went a couple of weeks ago. He slept over hooked up. We went back to see the Stanford doc and, although he didnt yet have the results, he looked at Sam again and didnt think he would need surgery.

He called us yesterday and said the results were pretty bad.

12 episodes of apnea over a 7+ hr period.
He woke up 15 times
Longest time without breathing was 13 seconds and his oxygen level went to 92%. Lowest o2 level was 89%
RDI during normal sleep was 2.4
RDI during REM sleep was 4.7.

Bottom line is he suggests removing tonsils and adenoids, work on the turbinoids in his nose and a pharyngoplasty. He said tonsils and adenoids wouldn't be enough.

I have been googling the pharyngoplasty and have been less than thrilled with what I see. The doc says all in it will take an hour and be done outpatient. I haven't seen pharyngoplasty on this site. Does anyone have an opinion or experience with this?

Thanks again,
Mark

Maybe I've missed something, not having read an earlier post.
But these results don't seem bad to me.  RDIs are less than 5 per hour, which puts it in in the normal range, not even mild.
(Apnea is defined as 5 or more AHI or RDI).  And although the oxygen levels did dip, it isn't significant.  Guess this is why I wonder why it's described as bad.  Perhaps I don't understand the situation.  Also, I don't know anything about the other surgery, perhaps others do.


Linda

i agree with linda that doesnt sound bad at all although any kind of stopping breathing is not nice it seems it wasnt in the dangerous level

im not expert with OSA my son has central sleep apnoea. but reading them results i wouldnt be worried by 12 apnoeas in 7 hours, longest 13 seconds, ok he did drop 02 levels but we was told everyone drops sats in there sleep.

i persoanlly wouldnt go for surgery on those results without discussing thinsg further

good luck

I would think just Tonsils and adenoids would help.  I would also find out why he thinks the other pieces need to be done.
With my Daughter the ENT looked at her tonsils and listened to her talk and said he was pretty sure she was ok and wouldn't need surgery, but he'd do a sleep study to humor us.  When the study was back she was kind of in the middle of the mild area for her apneas, and we went back for our follow up.  The ENT wasn't all that gung ho even then but said the T&A was probably the next step to try, and for the heck of it used the camera to actually look at her adenoids.  He said wow those are about the biggest adenoids I've ever seen, so then he thought surgery would help.  
Maybe you can get you ENT to actually take a closer look and see what they think then.  As far as I can tell the pharyngoplasty is a lesser form of the UPPP surgery that is talked about on the adult portions of the board, but from those posts it doesn't seem like its a whole lot of fun.
not sure if that helps any but some from our experiences,
Sarah J

A UPPP is a big jump from a tonsyls/adenoids surgery.  It is a miserable (and usually long) recovery, and the results are often less than impressive.  I know the folks out at Stanford are excellent, and you are getting great care there.  

You said a "pharyngoplasty is a lesser form of the UPPP"...

I think maybe what people were referring to when they said "pharyngioplasty" is a Laser Assisted Uvula pharyngioplasty (LAUP).  This isnt much more fun than a UPPP, and as far as numbers for success rates that I've read, it's somewhere in the 30-50% range.  

A T&A surgery is often done by itself with better success, and I usually see several other treatment options attempted before a UPP/LAUP is considered (which are usually reserved for the most severe cases  anyway).  
Good luck

Tim