In recent years, Dr. Weiner has become the leading sleep apnea surgeon in the Phoenix metropolitan area. He is passionate about helping patients with sleep apnea due to the significant health consequences if the sleep apnea is not adequately treated. He believes that there is no single treatment that is best for all patients and that an individualized treatment plan is needed.
In 2018, Dr. Weiner became certified to perform implantation of a hypoglossal nerve stimulator (Inspire) for patients with moderate to severe obstructive sleep apnea who cannot tolerate CPAP therapy.
He is now the most experienced surgeon performing this procedure in the western United States and is recognized by Inspire as a member of their Excellence Program.
In addition to Inspire, Dr. Weiner offers other sleep apnea procedures including modified uvulopalatopharyngoplasty (UPPP), expansion sphincter pharyngoplasty (ESP), epiglottis stiffening operation and the Airlift™ hyoid suspension procedure. This is important as some patients are not candidates for Inspire and other patients may be better served with an alternative procedure. Sometimes, Inspire is combined with other procedures to maximize success.
When a patient is seen in consultation for their sleep apnea, Dr. Weiner carefully reviews prior sleep studies and treatments already used. Next, a detailed examination of the patient's airway is performed. As a sleep apnea surgeon, he can critically assess the likely anatomic causes for the sleep apnea. This is vital to determine what alternatives to PAP therapy are most appropriate for the patient.
After this examination, it can be determined if there are good surgical options for treatment. In some cases, continued use of PAP therapy (CPAP, bi-PAP, APAP, etc.) or possibly use of an oral appliance may be better options. Although he is a sleep surgeon, his philosophy is to help guide the patient to the best option as surgery is not always the best option. He works with leading sleep medicine specialists, sleep dentists, sleep neurologists and sleep psychologists to achieve the best outcomes for his patients.
Millions of Americans suffer from sleep apnea, but only 20% are ever diagnosed and treated. Untreated it is a serious risk factor for health complications, such as heart disease and depression. Dr. Weiner is one of few surgeons specially trained and experienced in the correction of sleep apnea.
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Snoring affects more than half of all adults. This can impact the sleep quality for the patient but also of sleeping partners. Dr. Weiner can assess the possible causes of the snoring and determine what treatments may be helpful to reduce the severity. Frequently, nasal obstruction is present, and correction of the nasal obstruction may be helpful. Additionally, snoring surgery can also be performed to reduce the vibration of the tissues in the throat.
While total resolution of snoring is not always feasible, meaningful reduction is often possible.
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Dr. Weiner now offers a palate lift procedure (barbed Roman blinds technique), a non-invasive procedure to lift and tighten the tissues of the soft palate to treat snoring and mild obstructive sleep apnea.
The palate lift procedure (barbed suture pharyngoplasty) is a non-invasive treatment option for the treatment of snoring. It is performed through the mouth. To learn more about the palate lift, watch here:
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The Inspire system is made of a small battery and 2 small wires. Inspire is placed under the skin of the neck and chest through two small incisions during an outpatient procedure. Most patients return home the same day and return to non-strenuous activities within a few days. Over-the-counter pain medicine is typically used for a few days after the procedure for pain management.
Inspire therapy is a very good option for patients with moderate to severe sleep apnea who cannot consistently use PAP therapy. There are criteria which determine if a patient is a candidate for this procedure.
AirLift™ is a simple and effective treatment for Obstructive Sleep Apnea (OSA). It's an intuitive approach to hyoid & tongue suspension designed to provide immediate and lasting relief by opening and stabilizing the airway. AirLift is easy to implant, comfortable and covered by insurance. The AirLift procedure can be performed in as little as 30 minutes by a physician.
KEY PATIENT BENEFITS:
Airway Obstructed during Sleep
Airway Opened and Stabilized with the AirLift Procedure
AirLift is an alternative to CPAP
Airlift is a long-lasting sleep apnea solution – there's nothing additional to do to get a great night's sleep, no awkward mask or oral appliance to wear, no air pressure adjustments to make, and no batteries to charge.
AirLift is minimally invasive, adjustable and reversible
AirLift offers a less invasive, highly-effective option for OSA when compared to traumatic surgeries such as genioglossus advancement, midline glossectomy, or palate surgery and tonsilectomy.
Dr. Weiner is interested in helping to improve the patient selection process as well as treatment outcomes for sleep apnea surgery including hypoglossal nerve stimulation therapy (Inspire). In 2021, he developed a measurement tool to assess the internal dimensions of the patient's throat in the office. This had not been done elsewhere previously.
He then wrote a paper (with co-authors at the University of Arizona College of Medicine- Phoenix and Vanderbilt University) describing this measurement and its clinical significance. This has recently been submitted for publication. He is now leading a national study as Principal Investigator at 10 medical centers across the US to further study the application of this measurement in patients with obstructive sleep apnea who are candidates for hypoglossal nerve stimulation (Inspire).
A Noninferiority Analysis of 3- vs 2-Incision Techniques for Hypoglossal Nerve Stimulator Implantation. Kent DT,Chio EG, Weiner JS, Heiser C, Suurna MV, Weidenbecher M. Otolaryngol Head Neck Surg. 2021 Nov 30. Epub ahead of print. PMID: 34846979. http://journals.sagepub.com/doi/10.1177/01945998211062150
This article co-authored with 5 academic surgeons, assessed the outcomes of hypoglossal nerve stimulation therapy(Inspire procedure) when the surgery is performed through 2 incisions rather than the original 3 incisions. We demonstrated equal outcomes with reduced operative times and higher surgeon satisfaction.
Hypoglossal Nerve Stimulator Implantation via a Two-Incision Technique. Kent DT, Weiner JS, Chio EG, Weidenbecher M. Operative Techniques in Otolaryngology - Head and Neck Surgery. 31(3) September 2020, pages e35-e42. https://linkinghub.elsevier.com/retrieve/pii/S104318102030035X
This article, co-authored with 3 academic surgeons, describes a new way of performing the Inspire procedure using just two incisions rather than the standard 3. This innovation changed how the surgery is done around the world. Within a few months of FDA approval of the change, 97% of the procedure worldwide were performed with the new technique.
Case Report: Lateral Chest Placement of IPG for Hypoglossal Nerve Stimulator Implantation. Weiner JS. Laryngoscope, 00:1–3, 2020 https://onlinelibrary.wiley.com/doi/10.1002/lary.28950
This article describes an innovative surgery to place the Inspire device in a woman with a history of breast cancer and breast reconstruction. This approach hid the incision for the nerve stimulator.