Pediatric ear, nose and throat

New surgical technique cures Bryson’s sleep apnea

Teenage Bryson Yanke on a boat with a group of people, all wearing lifejackets
The Yanke family

Bryson Yanke, 15, had been struggling for years with poor quality of sleep.

Especially during the last two years, he found it difficult at times just to stay awake during the day. Falling asleep in school or at a doctor’s appointment became more commonplace, thanks to the contribution of his obstructive sleep apnea – a condition defined by frequent sleep interruptions resulting from intermittent blockages to the airway.

Born with Down syndrome (or Trisomy 21), Bryson is one of the approximately four in five children with Down syndrome who also experience sleep apnea. A narrower airway – usually associated with Down syndrome – is more prone to obstruction, especially when the tongue slides back during sleep. With constant interruptions during the night, the child often wakes up sleep-deprived before the day even begins. For Bryson and his family, a cure for his poor sleep seemed elusive.

Adopted at age 4 by Jill and Dave Yanke of Cottage Grove, Wisconsin, Bryson underwent several sleep studies at Wisconsin Sleep in Madison, a sleep clinic and laboratory run by UW Health and UnityPoint Health – Meriter. His first sleep study at age 7 – which involves spending the night hooked up to equipment that monitors sleep quality – was inconclusive. Several more studies were done, but the sleep apnea only intensified. By age 11, another approach -- orthodontia work – was tried. Although this improves sleep for some children, it didn’t help Bryson.  

Finally, at 14, Bryson returned for one more sleep study that ultimately set the stage for a different path that led to brighter light at the end of the tunnel.  

“The bad news from the last study was that Bryson’s sleep apnea seemed more definitive,” says UW pediatric sleep specialist Dr. Cami Matthews. “The good news was that our colleagues in pediatric ENT (ear, nose and throat) at American Family Children’s Hospital were ready and willing to help.”

Surgery seen as possible solution

After he was seen at UW Health’s pediatric ENT clinic, Bryson was deemed a candidate for a three-pronged surgery that had never been performed all at once in Madison. The procedure, which was done in January 2021, included a drug-induced sleep endoscopy (to identify the obstructed areas) followed by removal of the lingual tonsil tissue from the back of the tongue, and ended with a wedge glossectomy to remove a section of tongue muscle.

“We were able to carefully target Bryson’s obstructed airway and safely remove enough tongue tissue to significantly improve his breathing without compromising swallowing function,” says Dr. Michael Puricelli, a UW Health pediatric otolaryngologist (ear, nose and throat surgeon) who performed the operation. “Bryson now sleeps better and, more importantly, is more alert during the day and his quality of life is improved.”

Dr. Puricelli also credits American Family Children’s Hospital for investing in a new piece of equipment – known as a Coblator – that uses plasma-technology to carefully remove just enough tissue to cure Bryson’s sleep apnea.

After one night in the hospital, Bryson went home with relatively little pain – something that can be a short-term side effect from this surgery.  

“Before the surgery, he was having sleep interruptions about 8 times an hour,” says his mother, Jill. “Sometimes, if he stayed awake, he would make sounds that woke the other kids, who would yell, ‘Bryson’s making noise!’”

Huge improvement in Bryson’s sleep quality

Since the surgery, Bryson, a freshman at Stoughton (Wis.) High School, is having less than 2 sleep interruptions an hour (1 is considered normal). Instead of being the first one up in the house each morning, he sleeps in like a typical teenager. His parents couldn’t be more grateful. 

“We are very pleased,” says Jill, a mother of nine children – ages 9 to 26 – and grandmother of four. “We really wanted a permanent solution for Bryson -- not just something that would treat the condition, like a CPAP machine that would require constant cleaning and maintenance. Even better, Bryson will now have a greater sense of independence, which is something we wanted him to achieve. We will keep a close watch on him, as things can change in adulthood, but for the relatively small risk that comes with any surgery, this experience gave our son and our family a very large return.”