Surgery For Sleep Apnea

For decades, a tracheostomy was the only effective treatment for sleep apnea. Today, it’s only used in very rare, intractable cases.

More recently, surgery for sleep apnea involves one or more of several options, tailored to the patient’s needs. However, the long term success rate is generally low, prompting many doctors to favor CPAP as the treatment of choice.

Here are some options for those considering surgery for sleep apnea:

• Nasal surgery, including turbinectomy (removal or reduction of a nasal turbinate), or straightening of the nasal septum, in patients with nasal obstruction or congestion which reduces airway pressure and complicates OSA.
• Tonsillectomy and/or adenoidectomy in an attempt to increase the size of the airway.
• Removal or reduction of parts of the soft palate and some or all of the uvula. Variations of this procedure sometimes use radio frequency waves to heat and remove tissue.
• Reduction of the tongue base, either with laser excision or radio frequency ablation.
• Genioglossus Advancement – a small portion of the lower jaw which attaches to the tongue is moved forward to pull the tongue away from the back of the airway.
• Hyoid Suspension – the hyoid bone in the neck, another attachment point for tongue muscles, is pulled forward in front of the larynx.
• Maxillomandibular Advancement – a more invasive surgery usually reserved for difficult cases where other surgeries have not relieved the patient’s OSA, or where an abnormal facial structure is suspected as a root cause. The patient’s upper and lower jaw are detached from the skull, moved forward, and reattached with pins and/or plates.
• Pillar Procedure – three small inserts are injected into the soft palate to offer support, reducing snoring and sleep apnea.

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