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Question 2 - Submucusal Lingualplasty Surgery?

From: David B.

If you could provide more info on the operation and the recovery from it. I recently have had an UPPP/GI advancement and palatal advancement done in Jan 2007. My apnea actually increased to 34 from 30 but less duration (1.5 minutes without breathing to 40 seconds). My surgeon has recommended Submucusal Lingualplasty surgery which will reduce the size of the back of the tongue. My tongue is twice the size of a normal tongue (By MRI scan). He also said that if this didn't work, then it would be a further tongue reduction operation and if that didn't work then a MMA would be considered.

He also said that the Stanford surgeons don't normally use this operation as it was developed by Australian surgeons. Why is there a big difference in treatment in USA from Australia. I have been finding it hard to find any info on this operation. Can you help with info on operation and recovery?


Answer Provided by Dr. Kasey Li
June 15, 2007

The submucosal lingualplasty procedure was derived from the median partial glossectomy performed back in the early 80s. There were 4 or 5 papers published back then documenting moderate to significant improvement of OSA. However, the procedure is not as successful as MMA and is quite morbid, thus the procedure is not really done anymore.

Submucosal lingualplasty preserves most of the mucosa (surface of the tongue) while resecting tongue muscle (some people use radiofrequency energy to cut as oppose to the more common radiofrequency energy to shrink). Obviously, the more you resect, the more volume is reduced. I do not perform the procedure as I do not think that the procedure is nearly as effective as MMA. I would estimate that risks are bleeding, infection, injury to the motor nerve of the tongue, speech and swallowing issues not to mention failure of the procedure.

I anticipate recovery would be about 2 weeks and suspect that there can be fair amount of swelling postoperatively. When ever I am asked about procedures or surgeons, my answer is usually “request 2 or 3 references (patients who have had the same/similar procedures) from your surgeon”. If your surgeon can not provide you with 2 or 3 patients that have had decent results, RUN!

I hope this is helpful.
Good luck.

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