Has anyone had exp with Tonsillotomy vs having a Tonsillectomy for OSA?

Here is a link if you are not familiar:
http://archotol.ama-assn.org/cgi/reprint/132/6/599.pdf

Also, for those that have had either, did it help with CSA ... or just OSA?

Thanks,

Jen

Jen,

I don't have any experience with either surgery, as our son has central sleep apnea. Removing the tonsils will NOT resolve central sleep apnea...Anyone who tells you this, does not understand the nature of central sleep apnea...

Good luck!

Tiffany..Mom to Isaac, my three year old (finally potty trained) boy who still carries the official diagnosis of "Unresolved Primary Central Sleep Apnea of Infancy"...and to Esther Rose..My beautiful 3 month old Princess who seems to add a new specialist to her line up every week!

"Removing the tonsils will NOT resolve central sleep apnea...Anyone who tells you this, does not understand the nature of central sleep apnea... "

Was actually a pedi that said this last week.
I am having trouble trying to understand how this could possibly be so ...
The only thing I can come up with is OSA possibly triggering an autonomic response.
Much of the time when Ava desats, it is an autonomic issue.
Thanks ... I am still trying to figure out CSA.

Jen,

Central apneas can be caused by obstructive apnea, but you can't know that without a well done sleep study (it would show central apneas following obstructive hypopneas or apneas).  

Central sleep apnea is this: The brain failing to trigger the body to breathe for one of two reasons:

1. The brain perceives some danger of aspiration and instructs the body to pause its routine breathing so as to allow the danger to pass. The "perceived danger" can be reflux, large tonsils or adenoids, or even a large tongue or one that falls back into the throat during sleep.  In these cases, removing whatever the "danger" is, will often remove the bulk of central sleep apneas.

2. The brain actually falls asleep and forgets to tell the body to breathe until the CO2 level reaches a level that acts almost like an alarm clock to wake it back up and take a breath.  There are numerous options for treatment of this form, none of which involve surgery.

I guess my previous statement isn't entirely accurate, because if the centrals are being caused by the obstructives, then the removal of the tonsils/adenoids would indirectly remedy the central apnea, too...

Tiffany

Tiffany.
Thank you VERY much.

Ava has had a sleep study at a place that claims is one of the best north of CT ...
Of course I question that as I am not entirely trusting of the hospital it is associated with.

Now I do trust the interpreter of the study as I met him years ago for sleep related issues ... I do believe he is the one that began the lab.

I have been in contact w/ the ENT that authored the above article and he wants Ava to have another and we will go from there. Now I just need to find a place that will do the study sooner rather than later. Anyone have any suggesttions for places in NE? The one Mass E & E uses is booking 4 to 6 weeks out. I love digitrace (sleepmed) but they will not do sleep studies on young children.

Anyway, both your statements, 1 & 2, certainly could apply to Ava.

She has a very quirky nervous system as well her tonsils seem to swell often ... I think some from allergies and so forth.

I am curious  about co2 ... Ava has issues here too, only her CO2 is on the low side, sometimes to the point of acidemia/acidosis & intervention is needed .
It has been an ongoing issue that we have not been able to pinpoint cause.
Wonder if it spikes during sleep and when it falls it falls too much.