Surgical Interventions

Surgery

 

Most patients also think that surgical procedures are relatively quick, easy, and successful. Although surgery can be used for treatment of sleep apnea, it should be evaluated by the patient as well as the physician who would be performing the surgery to evaluate the implications and side effects for undergoing these surgical procedures.

 

Like any surgery, surgical intervention for treatment of obstructive sleep apnea does carry a certain level of risks. Surgical intervention to treat sleep disordered breathing (obstructive sleep apnea, primary snoring, etc.) can have results that may be unpredictable from the initial consultation or even during the surgery and may result in no change in their sleep disorder or it could possibly make it worse.

 

Surgical interventions for treatment can occur in different areas of the patient’s anatomy.

 

 

Enlarged Tonsils and Adenoids

 

Nasal surgery

 

Nasal surgery has different areas that can be used to address sleep disordered breathing.

Correcting a deviated septum septum (a bent or crooked cartilage within the nose between the left and right nostril) focuses on straightening the cartilage and making a better and more streamlined airflow into the nasopharynx. Patients who have a deviated septum typically have one nostril that they are able to breathe through relatively easily and one nostril that typically is either very difficult for airflow or lacks airflow altogether. Patients undergoing PAP titration will find it extremely difficult to tolerate PAP while suffering from a deviated septum

 

Nasal surgery can also involve widening the nares (openings of the nose) to allow more airflow into the nostrils thus decreasing the overall work of breathing.

 

Removing growth or polyps within the sinus cavity will also open up the sinuses allowing individuals to breathe air more easily decreasing air resistance and decreasing the overall work of breathing. There is surgery for turbinate reduction. The turbinates are folds of tissue within the sinuses that help filter, warm, humidified the air that we breathe in. Occasionally patients will have swelling that is a chronic condition in the turbinates and this can be reduced with certain surgical procedures.

 

Oral surgery

Oral surgery comes in many different fashions that include the minimally invasive all the way to the extreme evasive surgeries. 

 

Laser-assisted uvula plasty involves the patient’s uvula (little dangling thing in the back of your throat) that is cut away (using a laser) and is done in the ENTs office with a local anesthetic. This is a procedure that can be done for treatment of snoring.

 

Tonsil and adenoidectomy is typically done on pediatric patients and young adults who have very enlarged tonsils and adenoids. Removal of the tonsils and adenoids open the oropharynx allow air to enter the lungs more readily thus decreasing the likelihood of having OSA.

 

Uvulopalatopharyngoplasty (UPPP) is the most invasive where the soft palate, uvula, tonsils are all surgically removed. This is done in a hospital setting.

 

Roughly speaking, surgery or treatment of obstructive sleep apnea has a variable success rate of between 40 to 60%. Thus, in essence you have a 50-50 chance that any of the surgical procedures listed above will resolve your sleep disordered breathing