Base of Tongue Reduction for Severe Obstructive Sleep Apnea

Fauquier ENT is offering a relatively new procedure called base of tongue reduction (as well as lingual tonsillectomy) using coblation for patients suffering from severe obstructive sleep apnea (OSA) due to an enlarged base of tongue. For many patients, an enlarged base of tongue is a significant contributing factor leading to severe sleep apnea. This area contributes to obstruction by falling backwards against the back wall of the throat during sleep leading to airway closure.

Although a number of procedures have been offered to minimize this problem in the past such as:

• hyoid advancement
• genioglossal advancement
• repose procedure
• mandibular advancement

None of these procedures directly addresses the tongue bulk/size itself. Rather, these procedures indirectly attempts to address the base of tongue by moving and anchoring the entire tongue forward. As such, these procedures only marginally improves OSA and usually only lasts for a temporary period of time.

Other traditional OSA surgeries such as:

• tonsillectomy
• adenoidectomy
• UPPP (uvulo-palato-pharyngoplasty)
• septoplasty
• turbinate reduction

These address obstructions only at the nasal and oral cavity level of the airway. Base of tongue is BELOW these levels and located immediately above the voicebox (where air enters the windpipe to get to your lungs). As such, many patients who have undergone these surgeries often find themselves still suffering from OSA. Furthermore, enlarged base of tongue is the main cause of OSA in skinny people.

Click here to read more about base of tongue reduction/lingual tonsillectomy offered only at Fauquier ENT of Northern Virginia.

Additional Surgery Time on Fridays Available

By patient request, our office now has time available for surgery on Fridays (to allow healing over the weekend). These cases will be done at the Prince William Ambulatory Surgery Center. Given theses cases will be done in an ASC setting, only patients who are healthy will be eligible.

Normal Post-Tonsillectomy Appearance

Often, patients become disturbed with the way their throat looks after a tonsillectomy. However, many of the concerns are unfounded and the appearance though disturbing, is actually normal. The white plaques where the tonsils used to be are actually scabs. Just like a scab on a cut elbow turns white after taking a shower or swimming, the scabs in the throat/mouth turn white from the saliva. Also, the uvula is swollen (3-4X bigger than usual) which also is normal and will improve over the weeks. Hopefully, the NORMAL picture shown here will reassure patients who are concerned with their throat appearance after tonsillectomy.

This particular picture was taken 7 days after tonsillectomy.

Patient Testimonials

A new webpage has been added listing testimonies from patients as well as visitors to our website. Click here to take a look.

Instruction on Correct Amounts to Use for Allergy Shots

New information with pictures has been added to our instructional webpage on how to administer correct doses for allergy shots. Given many non-allergy physician offices find themselves giving allergy shots due to patient convenience, our office has created this information to ensure mistakes are not made due to unfamiliarity.

Click here to check it out!

Phone Reminder System Upgrade

We have recently upgraded our practice's phone appointment reminder system to Televox. We hope that people like this system better than our prior system. Appointment reminders will be called 2 business days prior to a scheduled appointment.

Also, we will begin calling patients who are giving themselves allergy shots at home when their allergy vial is soon going to expire. As allergy patients should know, using an expired allergy vial is dangerous and requires one to re-build back up to maintenance in a physician office with the new allergy vial. These calls will be made one month prior to an expiration.

Laryngospasm Pressure Point

I just learned of a new technique (well, actually it has been around for at least half a century) that may help patients who suffer from laryngospasm attacks. It is actually a technique used by anesthesiologists to abort laryngospasm while a person is under general anesthesia. Basically, there is a "pressure point" known as the laryngospasm notch located right behind a person's earlobe, but in front of the mastoid bone. One needs to press very firmly deep and forward towards the nose on both sides when an attack occurs. If performed properly, it should hurt quite a bit and resolve the attack quite rapidly (within 10 seconds). Here is a link to a journal article on the laryngospasm pressure point.

Read more about vocal cord dysfunction and laryngospasm here.