Thanks to Bill Gatti, Penny Crowley can throw out her earplugs. Every night Penny's
husband, Al, a kind, funny, mild-mannered dentist, would metamorphose into a snarling,
snorting monster as soon as he fell asleep. He was a snorer. And every night Penny Crowley
would cower under her covers, trying to block out the noise with thick earplugs, sometimes
fleeing the bedroom in frustration.But today, thanks to Dr. William Gatti, a
Libertyville ear, nose and throat specialist, the sounds of silence blanket the Crowleys'
Bannockburn bedroom. Gatti snuffed out Al's snores with a painless, bloodless and
extraordinarily effective procedure called laser assisted uvulopalatoplasty.
"No more earplugs for me. No more sleeping in hotel bathtubs when we go on
vacation and I forget to bring earplugs," Penny sighed euphorically. "Bill Gatti
has made my life so much nicer. Now I can actually drift off to sleep next to my husband
... after 31 years."
A pioneer of cutting-edge technology in the Chicago area for many years, the
56-year-old Gatti has brought the joy of speaking and hearing back to hundreds of
patients. Yet nothing excites the Bannockburn resident more than the revolutionary LAUP
procedure, as it's known. Since introducing the procedure to Lake County about a year ago,
Gatti has silenced about 300 rattling, shattering snores.
"As far as complications go, there are none with this procedure. I can say that
categorically. The only thing they'll have is a sore throat for a few days. There's no
voice change, no swallowing difficulty. It's relatively pain-free, bloodless and
quick," Gatti asserted. "And it's an office procedure, done with local
anesthesia, with a very high cure rate of 85 to 90 percent."
The American Academy of Otolaryngology estimates that 21 million adults snore through
the night. Habitual snorers tend to be male by a 3-to-1 margin, but by the age of 60, 60
percent of all men and 40 percent of women snore.
The LAUP (pronounced lay-up) procedure literally vaporizes the problem at the source,
which in most cases is the uvula, the fleshy finger-shaped tissue dangling in the back of
the throat, and the soft palate, which separates the throat from the nasal passages.
During sleep, throat muscles relax, inhaled air rushes in, and the slack tissues in the
uvula and soft palate begin to vibrate.
"When the palate is long, it may narrow the passage and act as a flutter valve
that vibrates louder. A long, dangling uvula vibrates," Gatti explained. "And
the noise it produces is quite loud."
He noted that a crying baby can reach 60 decibels, a jackhammer blasts out 72 decibels,
but a championship snore can shatter domestic bliss at 90 decibels, comparable to a power
mower.
In the LAUP procedure, Gatti uses a carbon dioxide laser beam to reshape and thin the
uvula during two to five office visits scheduled four weeks apart. Each treatment takes
about 30 minutes.
"It's a little like peeling an onion. You're taking layers of tissue off the uvula
a little at a time. The soft palate starts to scar, which causes it to lift and
stiffen," Gatti said. "It raises and stiffens the palate like a theater curtain
and allows more room for air flow."
Not surprisingly, most of his patients have been sent by their spouses. "I had two
patients in the last month who are newly married, and their wives already sleep in another
room," Gatti said. "They can't get a minute's sleep."
Although marital disharmony grabs the most attention, snoring is more than just noise
pollution. Gatti reeled off an impressive list of ills that can befall a snorer, among
them marital stress, work difficulties, insomnia, morning headaches, short-term memory
loss, fatigue, and daytime sleepiness that can cause auto accidents. Perhaps the most
dangerous consequence is the potential link with sleep apnea, a serious medical condition
that causes a person to stop breathing.
According to Gatti, habitual snoring is to sleep apnea as angina is to a heart attack.
"There's constant oxygen deprivation," Gatti explained. "While only 1 in
100 loud snorers have sleep apnea, if that person stops breathing for longer than 10
seconds, or if it happens more than seven times an hour, apnea can lead to potentially
fatal hypertension, stroke, pulmonary and cardiac problems. It can be a precursor to a
heart attack."
While more than 30 percent of Gatti's patients are female, some tend to be
"closet" snorers. One female patient couldn't stop raving about how "Dr.
Gatti's such a dear man. So patient and sweet. He explains everything so well. He even
scheduled my surgery on a school holiday so I wouldn't have to miss an hour of work."
But she wouldn't allow her name to be used because "my husband owns a business, and
he doesn't want people to know I snore ... or I did at least."
Developed in France in 1987, the LAUP arrived in Chicago in May 1993, when ear, nose
and throat specialist Dr. Regina Walker brought the advancement back to Loyola Medical
Center near Maywood. She offered a training workshop that August, and one of the first
physicians to sign up was Gatti. Walker was delighted but not a bit surprised. After all,
Gatti had trained her when she was a resident at Loyola Medical School from 1985 to 1989.
"Bill was a wonderful professor, and he's a wonderful student. He's extremely
organized and never late. He knows so much, he gave me hints that really help when I teach
the LAUP procedure," Walker said. "I send him all my LAUP patients who don't
want to travel to Loyola."
Gatti grew up knowing that he wanted to be a surgeon after listening to his physician
father, Joseph, tell Gatti's mother, Mary, about his day in the operating room.
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Born in 1938 in Teaneck, N.J., Gatti was the oldest of four children from a strong
Catholic background. After he finished his undergraduate work at the University of Notre
Dame and started medical school at Loyola University Medical School, with training at
Hines Veterans Administration Hospital in Maywood, he zeroed in on the field of
microsurgery.Completing an otolaryngology fellowship at New York University Medical
Center, he spent two years at Great Lakes Naval Hospital, then returned to Hines and
Loyola Medical Center and Dental School as associate professor, then director of the
department of otology and acting chairman of otolaryngology.
It was at Hines that his pioneering spirit sprang to life. In the late 1970s he introduced
an Italian method of reconstructive surgery on the larynx for cancer patients. To avoid an
esophageal voice that sounded like "burping up air from the stomach," he
diverted air from the lungs to the upper airway, then to the mouth. "There was a
remarkable difference in the voice," Gatti recounted.
Gatti also initiated the first use of surgically implantable electromagnetic hearing
devices in Illinois to correct conductive hearing loss, which occurs when sound waves
can't travel through the middle ear or ear canal to the inner ear, where the auditory
nerve is located.
"Only an estimated 500,000 people have conductive hearing loss. But now there are
similar techniques being tried out for the millions of people who suffer from sensory
nerve hearing loss from aging and exposure to excessive, loud noise," he said.
"We're talking about implantable devices, not hearing aids."
In recent years he has chiseled through a 30-layer wall of bone in the inner ear,
reconstructed eardrums with biomaterial, a substance composed of the same material as
living bone, and started to perform outpatient laser assisted serial tonsillectomies
(LAST).
Gatti prefers not to be regarded as a "super-specialist," but rather as a
general ear, nose and throat doctor who enjoys challenges.
"He's excited by challenge. Everything he does, he does with an enormous amount of
energy and enthusiasm," said his wife, Dr. Florence Long Gatti, a staff radiologist
at St. Francis Hospital in Evanston. "He's always filled with ideas, trying to make
things better for his patients. He's never content with things the way they are. He's
always asking, `What if I did it this way?"'
Married 30 years this November, the couple met in medical school when he was class
president and she was secretary of the class. They raised their four children, John,
William, Joanne and Lauren, in Deerfield from 1971 to 1977, then moved to Bannockburn.
In 1990, after 18 years of teaching at Loyola, Gatti added another challenge to his
life by hanging a shingle closer to home. "I had never tried private practice, and I
wanted to give it a shot before I got too old," he recounted.
Florence agreed with the decision. "Bill thought the time was right to try it out.
He took a chance, leaving his tenure, salary and friends to start in Lake County."
His one and only call for advice was to Dr. John Van Nuys, an ear, nose and throat
specialist he had met through a mutual friend 20 years ago. Van Nuys
"graciously" offered to share his office space in Gurnee while Gatti was
establishing a practice.
"I knew Bill from years before. It's not easy for a guy his age to come out and
start from scratch," Van Nuys acknowledged. "He's doing very well, and he'll
continue to be successful because he's very innovative."
Indeed, only Loyola's Walker has done more LAUP procedures in the Chicago area. Gatti
is now on staff at Condell Medical Center in Libertyville, Victory Memorial Hospital and
St. Therese Medical Center in Waukegan and Lake Forest Hospital as well as Loyola Medical
Center.
LAUP procedures run $125 for initial evaluation and $500 for each laser session. The
average number of treatments is three, but some patients need two and some the maximum of
five, depending upon the size and bulk of the tissue to remove. Most insurance companies
will pay a share of the cost for the procedure.
To make sure the LAUP works on snorers, "we have their spouses chart a `snore
level,' then rate it with 1 being the softest and 10 being the loudest. A number 2 or 3 is
considered a cure," Gatti said. "We know the surgery was successful when one
spouse tells the other, `Gee, I can sleep back in the bedroom again."'
If there is no spouse, Gatti added, "I have them put a tape recorder in the room
and record the snores. Virtually all my patients get down to a 2 or 3."
"Al went from a 10 to a 5 after the very first procedure," Penny Crowley
exclaimed. "Now he's down to a 3."
"A mild sore throat is nothing compared to being able to sleep quietly,"
acknowledged Al Crowley, who happens to be Gatti's dentist in Deerfield. "And after
the second treatment, we went straight out to an Italian restaurant!"
Gatti laughed when talking about Crowley. "The best part with Al is having him in
the chair, with his mouth full of equipment, not being able to talk, while I chat away.
Now, who wouldn't like to do that with their dentist?" |
