睡眠時無呼吸 （質問・回答＝英文）
相談者：
Absyさん (29歳：男性)
投稿日時：2014-10-01 16:27:53
はじめました、
アブスィです。
日本語で説明が難しいため、英語で失礼いたします。
I suffer from sleep apnea.
I had a tonsillectomy and septoplasty; which partially helped but the snoring and apnea is still there.
I know that my tongue and my soft palate are the source of the trouble.
I have a tongue larger than the average size. It causes in unclear pronunciation of some letters that requires tongue movement.
I searched online and found that tongue-base reduction somnoplasty might help.
I went to a local clinic in Tokyo, and the ENT told me somnoplasty is ineffective and cannot be done in Japan. And my only options are the cpap or mouthpiece.
I searched again online, and I found that there is an advanced technique to perform Midline partial glossectomy, which use the da vinci robot to reduce the size of the tongue to help sleep apena.
https://med.uth.edu/orl/newsletter/transoral-robotic-surgery-for-the-treatment-of-obstructive-sleep-apnea/
I wonder if there is any hospital in Japan where I can have Midline partial glossectomy. I do not want to put on CPAP while sleeping or use a mouthpiece.
長い英語でしつれいいたしました。
Midline partial glossectomyができるところを教えていただければ幸いです。
よろしくお願いいたします。
アブスィです。
日本語で説明が難しいため、英語で失礼いたします。
I suffer from sleep apnea.
I had a tonsillectomy and septoplasty; which partially helped but the snoring and apnea is still there.
I know that my tongue and my soft palate are the source of the trouble.
I have a tongue larger than the average size. It causes in unclear pronunciation of some letters that requires tongue movement.
I searched online and found that tongue-base reduction somnoplasty might help.
I went to a local clinic in Tokyo, and the ENT told me somnoplasty is ineffective and cannot be done in Japan. And my only options are the cpap or mouthpiece.
I searched again online, and I found that there is an advanced technique to perform Midline partial glossectomy, which use the da vinci robot to reduce the size of the tongue to help sleep apena.
https://med.uth.edu/orl/newsletter/transoral-robotic-surgery-for-the-treatment-of-obstructive-sleep-apnea/
I wonder if there is any hospital in Japan where I can have Midline partial glossectomy. I do not want to put on CPAP while sleeping or use a mouthpiece.
長い英語でしつれいいたしました。
Midline partial glossectomyができるところを教えていただければ幸いです。
よろしくお願いいたします。
回答1
アンドウ歯科クリニック(世田谷区世田谷)の安藤です。
回答日時：2014-10-02 03:16:26
Hi Absy,
Although I cannot help you find a place which will perform midline partial glossectomy for you in Japan, I hope the information I provide you here will be of some help.
First of all, I would like you to know that CPAP is THE gold standard for treatment of obstructive sleep apnea. It has been proven to improve large portion of patients with sleep apnea, no matter how severe it is. Neither tonsillectomy nor septoplasty has been proven to be as effective as CPAP for improving sleep apnea. Because CPAP is proven to be the most effective treatment, as a healthcare provider, we are obligated to recommend this as the first line treatment.
Of course not all patients can tolerate CPAP. Portability and compliance always seem to be the problem for most of the patients. Appliance is the next effective treatment option and UPPP （uvulopalatopharyngoplasty） is the next most effective surgical option. If you KNOW that your tongue and soft palate are the source of the problem, UPPP may help. （if you are seeking for treatment of lisp, go find a speech therapist.）
If you were told CPAP or mouth piece（appliance） are THE only option, your doctor is wrong. An UPPP, midline partial glossectomy, or even bilateral jaw advancement surgery may be another option. However, when risk and benefit considered, CPAP or appliance are by far the most beneficial treatment option. What I would like you to know is that midline partial glossectomy has not been proven to be as effective as any of the options I have mentioned earlier.
If you live in Tokyo and looking for an English speaking doctor specializing in sleep apnea, feel free to contact me. I am fluent in both Japanese and English, US trained, and specialized in treating sleep apnea.
Best regards,
Akihiro Ando, DDS
Although I cannot help you find a place which will perform midline partial glossectomy for you in Japan, I hope the information I provide you here will be of some help.
First of all, I would like you to know that CPAP is THE gold standard for treatment of obstructive sleep apnea. It has been proven to improve large portion of patients with sleep apnea, no matter how severe it is. Neither tonsillectomy nor septoplasty has been proven to be as effective as CPAP for improving sleep apnea. Because CPAP is proven to be the most effective treatment, as a healthcare provider, we are obligated to recommend this as the first line treatment.
Of course not all patients can tolerate CPAP. Portability and compliance always seem to be the problem for most of the patients. Appliance is the next effective treatment option and UPPP （uvulopalatopharyngoplasty） is the next most effective surgical option. If you KNOW that your tongue and soft palate are the source of the problem, UPPP may help. （if you are seeking for treatment of lisp, go find a speech therapist.）
If you were told CPAP or mouth piece（appliance） are THE only option, your doctor is wrong. An UPPP, midline partial glossectomy, or even bilateral jaw advancement surgery may be another option. However, when risk and benefit considered, CPAP or appliance are by far the most beneficial treatment option. What I would like you to know is that midline partial glossectomy has not been proven to be as effective as any of the options I have mentioned earlier.
If you live in Tokyo and looking for an English speaking doctor specializing in sleep apnea, feel free to contact me. I am fluent in both Japanese and English, US trained, and specialized in treating sleep apnea.
Best regards,
Akihiro Ando, DDS
相談者からの返信相談者：
Absyさん
返信日時：2014-10-03 00:02:40
Dear Ando先生、
Thank you very much for your helpful explanation.
By the way, your English is impressive and outstanding! Thank you very much.
I also would like to thank you for putting the time and effort to reply my post.
I forgot to mention that I am a singer. I do earn living from singing aside from my main job. I am considering midline partial glossectomy because my big tongue, which so back in my throat, cause me a trouble also when I sing （talk）, as well as when I am asleep.
as for the CPAP and mouthpiece; I know that I would not be able to tolerate them, and I do not want my life to depend on equipment or machines.
As for the UPPP, the doctor who made my tonsillectomy already trimmed my uvula so now it is so short （but soft palate it self still long and flappy）.
I am afraid that if I go UPPP then it will drastically change the characteristic of my nasality.
It is very unfortunate that I cannot not find a hospital here where they perform midline partial glossectomy or something to push the tongue base forward.
Finally, I would gladly visit you in your clinic for a health check and medical evaluation, if you would provide me the clinic address.
Thank you very much for your help and invaluable advice.
Best regards,
Absy
Thank you very much for your helpful explanation.
By the way, your English is impressive and outstanding! Thank you very much.
I also would like to thank you for putting the time and effort to reply my post.
I forgot to mention that I am a singer. I do earn living from singing aside from my main job. I am considering midline partial glossectomy because my big tongue, which so back in my throat, cause me a trouble also when I sing （talk）, as well as when I am asleep.
as for the CPAP and mouthpiece; I know that I would not be able to tolerate them, and I do not want my life to depend on equipment or machines.
As for the UPPP, the doctor who made my tonsillectomy already trimmed my uvula so now it is so short （but soft palate it self still long and flappy）.
I am afraid that if I go UPPP then it will drastically change the characteristic of my nasality.
It is very unfortunate that I cannot not find a hospital here where they perform midline partial glossectomy or something to push the tongue base forward.
Finally, I would gladly visit you in your clinic for a health check and medical evaluation, if you would provide me the clinic address.
Thank you very much for your help and invaluable advice.
Best regards,
Absy
| タイトル | 睡眠時無呼吸 （質問・回答＝英文） |
|---|---|
| 質問者 | Absyさん |
| 地域 | 東京23区 |
| 年齢 | 29歳 |
| 性別 | 男性 |
| 職業 | 会社員（技術系） |
| カテゴリ |
口腔外科関連 その他(その他) |
| 回答者 |
|
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