Sleep Apnea Treatment – Surgery

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If patients have not benefited from CPAP therapy or dental appliances, then they may need surgery to treat their sleep apnea.

Surgery options include a uvulopalatopharyngoplasty, radiofrequency ablation, septoplasty and turbinate reduction, genioglossus advancement, hyoid suspension, midline glossectomy and linugalplasty, maxillomandibular osteotomy (MMO) and advancement (MMA), palatal implants, weight loss surgery, laser-assisted uvuloplasty (LAUP), and tracheostomy.

Uvulopalatopharyngoplasty (UPPP)

During this procedure, the excess tissue in the throat is removed and repositioned to help make the airway wider. The surgeon will trim down the soft palate and uvula, remove the tonsils and reposition some of the muscles of the soft palate.

To treat moderate to severe sleep apnea, UPPP is usually combined with other surgeries that address other parts of the upper airway.

Radiofrequency Ablation

This is a treatment option for individuals with mild to moderate sleep apnea. During the procedure, the surgeon uses controlled cauterization to shrink and tighten the tissues in and around the throat, such as the soft palate, tongue and tonsils.

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Septoplasty And Turbinate Reduction

During a septoplasty, the deviated nasal septum is straightened to help improve the flow of air. Turbinate reduction involves reducing or removing the curved structures that stick out from the side of the nose. These structures may be enlarged by allergies and other reasons.

Genioglossus Advancement

This type of surgery moves the major tongue attachment forward and opens up space for breathing behind the tongue. During surgery, a cut is made in the lower jaw where the tongue attaches and a piece of the bone is moved forward.

Hyoid Suspension

The hyoid bone is a U-shaped bone in the neck that connects to the tongue and epiglottis. Surgery involves pulling the hyoid bone forward and securing it in place to increase breathing space in the lower part of the throat.

Midline Glossectomy and Lingualplasty

During these two procedures, a part of the back of the tongue is removed to help improve airflow. These procedures are rarely performed.

Maxillomandibular Osteotomy (MMO) And Advancement (MMA)

Patients with severe sleep apnea may benefit from this type of surgery. During surgery, the bones of the jaw are cut and the upper and/or lower jaw is moved forward to increase breathing space in the entire throat. The bones will need a few months to heal and the patient’s jaws may be wired shut for a few days. Patients will be on a limited diet for a few weeks after the procedure.

Palatal Implants

This procedure involves inserting small fiber rods into the soft palate to soften the tissue and prevent obstruction.

Weight Loss Surgery

Because one major cause of sleep apnea is excess weight, patients may need to undergo surgery. However, patients are encouraged to try other strategies to lose weight before considering surgery.

Laser-assisted Uvuloplasty (LAUP)

This treatment is less effective than UPPP but is less painful and has fewer side effects. During surgery, the soft palate is cut using a laser to scar and tighten it. The uvula is trimmed over numerous visits.

Tracheostomy

This procedure is very rare and is only used in emergency situations. A tracheostomy involves placing a hollow breathing tube directly into the windpipe in the lower portion of the neck. The tube may be plugged during the day, allowing the individual to breathe and speak normally. The tube is opened at night to allow breathing without any blockage in the throat.