What are the possible risks in the surgical procedure known as Repose
for sleep apnea?

davey62,

Being an educated patient can allow you to make informed medical
decisions, which can lead to a successful surgery and recovery! All of
the information contained in this answer is for informational purposes
only, and does not endorse any treatment or surgical procedure.

Sleep apnea is reported to affect 2-4 percent of the American
population, and is caused when the tongue base collapses, resulting in
obstruction of the upper airway passage. Sleep-related breathing
disorders range from simple snoring to severe sleep apnea, daytime
sleepiness, pauses in breathing, and cardiovascular consequences such
as hypertension and stroke

“Repose”  is a surgical procedure, otherwise known as the “Tongue
suspension procedure” for obstructive sleep apnea (OSA), approved by
the FDA in 1998. It is a potentially reversible procedure, whereby a
small titanium screw is inserted in the lower jawbone, and takes
around 30 minutes. Two nylon sutures are attached to the screw, which
are then passed through the tongue and tongue base. The sutures are
then secured. The sutures help preventthe tongue from flopping
backwards, when the patient lies down at night. The recovery time for
the Repose procedure is much  shorter  than other typical
procedures.However, there have been few studies to prove the efficacy
of this surgery and there is a scant amount of scientific research
published. http://www.sleepapnea.org/osa.html
(The above website was updated  4/21/2001)
http://www.pslgroup.com/dg/57D9A.htm

A short mention of the tongue suspension procedure, in the middle of
the page:
http://www.advanceforhim.com/pastarticles/apr15_02feature1.html

An additional description of the procedure is found at the bottom of
this web page:
In addition to these procedures, Dr. Sinha may also perform a tongue
base suspension. The back of the tongue is also a structure, which can
collapse into the airway. A simple sling of thin but strong suture,
anchored to the inside of the jawbone, is placed underneath the lining
of the floor of the mouth and tongue. This is usually not noticeable
during the day and, at night, prevents the tongue from falling back
into the airway.
http://www.drsinha.com/sleep_apnea.htm


A pictorial of the Repose procedure is found here: 
http://www.snoringtreatment.com/rtss.htm


The Influent Medical Products site has a Question and Answer page with
questions such as   “How does the surgeon know the screw is inserted
in the correct location”
Answer  ” By palpating the mandible bi-manually before insertion.
Proper screw positioning should be in the inferior third of the
mandible, below the teeth roots”
Influent Medical Products is the company that developed the “Repose”
technique.
http://www.influentmedical.com/Content/material/repose_faq.asp
The Influent Medical Products Home Page is
http://www.influentmedical.com/default.asp


I must say little is to be found about the risks of this surgical
procedure, especially since it is relatively new.

From The Medical College of Wisconsin
“Risks include numbness to the front middle teeth. Rarely, loss of a
tooth or jaw fracture may occur”.
http://healthlink.mcw.edu/article/994957808.html

In this study of 39 OSA patients, by B. TUCKER WOODSON, MD, FACS, et
al, there were “ 6 complications (18%), including sialadenitis (4),
gastrointestinal bleeding (1), and dehydration (1) after the
procedure.” (sialadenitis is an inflammation of the salivary glands)
http://www2.us.elsevierhealth.com/scripts/om.dll/serve?action=searchDB&searchDBfor=art&artType=abs&id=a102119&nav=abs

The American Sleep Apnea Association  says:  
“Physicians who perform surgery for snoring are most commonly
otolaryngologists (specializing in the ears, nose, and throat) and
oral and maxillofacial surgeons. If you are seeking a referral to a
surgeon or a second opinion, you may find one through your physician
or through a sleep center. Keep in mind that your insurance policy may
require you to get a referral for a specialist and/or to see a
specific provider. “
http://www.sleepapnea.org/snoring.html

According to Influent Medical Products, of the 19 patients studied “
Complications:
“There were no intraoperative complications. Postoperatively, four
patients suffered transient velopharyngeal insufficiency, and 2
patients complained of limited anterior excursion of the tongue. There
were no episodes of airway compromise, no extrusions of the suture,
and no cases of hypoglossal nerve injury”
(this means that no one had problems during surgery. Four patients had
some problems that came and went, with their soft palate and pharynx.
Two patients that they had limited bouts of their tongue pulling back)
http://www.influentmedical.com/Content/utility/ArticleDisplay.asp?ID=38&Index=4
A sleepnet forum, where you can read about other’s sleep apnea
experiences, including mention of the tongue suspension
(Repose)procedure.
http://www.sleepnet.com/noncpap2/messages/580.html
This is an excellent web page all about sleep apnea. Sadly, it has
nothing about the Repose Surgical Procedure. It may help explain sleep
apnea for you though - just additional reading.
procedure)http://www.emedicine.com/med/topic163.htm

I wish I could have found more information, but there really is little
to be found on this topic. If anything in the answer is unclear,
please don't hesitate to ask for an answer clarification.

Good luck,
crabcakes

Nice job

Davey62