Houston Plastic and Craniofacial Surgery
1-713-791-0700
Surgical Procedures to Treat Obstructive Sleep Apnea Obstructive sleep apnea (OSA) is a sleep disorder characterized by complete or partial obstruction in the upper airway during sleep. Obstruction in the upper airway may happen due to collapse of excess soft tissue in the soft palate, tonsillar pillars, tongue, tongue base, and hypopharyngeal walls, temporarily blocking the inflow of air. People under any age group can develop OSA and its symptoms include habitual snoring, labored breathing, observed apneas, restless sleep, and daytime neurobehavioral problems. Often, the patient is not the first one to recognize the signs. A person who observes the patient at rest may be the first one to notice the problem. Treatment Options for Obstructive Sleep Apnea Once OSA is diagnosed, the plastic surgeon will perform a physical exam and evaluate the medical and sleep history of the patient to determine the most suitable treatment method. Here are the different approaches to treat the condition: Tracheotomy: In this surgical procedure, the plastic surgeon creates a permanent opening or hole in the neck to the windpipe (trachea). A tube is inserted into the windpipe to let air in. The opening allows the effective movement of air, without touching upper airway, bypassing the upper throat, tongue, mouth, and nasal passages.
Houston Plastic and Craniofacial Surgery
1-713-791-0700
Tracheotomy is suitable to treat obstructive sleep apnea as the condition occurs due to collapses in the upper airway, leading to repetitive pauses in breathing. This issue can be greatly improved by removing the resistance of the upper airway. Tonsillectomy: Enlarged tonsils and adenoids are the usual reasons for obstructive sleep apnea in children. Tonsillectomy involves the removal of adenoids and tonsils that cause blockages in the child’s air passage, thereby helping to resolve sleep-related breathing disorder. Uvulopalatopharyngoplasty (UPPP): This procedure is used in cases when OSA is caused by an enlarged tongue. Excess tissues in the throat are removed to make the airway wider, allowing air to move more easily through the throat when the patient breathes. The uvula (soft finger-shaped tissue that hangs down from the back of the roof of the mouth into the throat), a portion of soft palate, tonsils, or adenoids are considered for removal, to make the airway wider. Genioglossus advancement: In this procedure, the muscles of the tongue base are advanced forward on a small piece of bone attached to the mandible. This places tension on the tongue musculature, restricting the posterior displacement during sleep. Hyoid myotomy: Hyoid myotomy is not usually performed as a standalone procedure but combined with other procedures to enlarge a portion of the airway. In this
Houston Plastic and Craniofacial Surgery
1-713-791-0700
case also, the muscles of the tongue base are advanced forward causing the tongue base to pull away from the back of the throat, thus enlarging the airway. Maxillomandibular advancement (MMA): In MMA, the bones of both the upper and lower jaw are cut and advanced forward. The procedure not only physically enlarges the airway but also puts the muscles of the airway under constant tension to prevent airway collapse. It can be effective for treating sleep apnea as well as other conditions such as high blood pressure, daytime sleepiness, depression, or concentration impairment. Distraction osteogenesis: Distraction osteogenesis is usually used for correcting OSA in children. In adults, it is used to avoid scarring from prior surgeries and severe bony abnormalities which were previously uncorrectable. Here, the distraction of lower bone is done by stretching it to create a larger and more anatomically normal bony shape. Houston in Texas has several plastic surgeons that provide treatment for OSA. Choosing an experienced boardcertified surgeon in an AAAASF-accredited surgical center providing sleep apnea treatment would ensure an optimal solution.