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In cases where obstructive sleep apnea (OSA) has become too persistent for a patient to bear or when conventional OSA treatments such as CPAP machines are not effective, then sleep apnea surgery is a treatment to consider. In OSA, the airway is blocked or constricted. Various surgical procedures have been developed to open or expand the nasal and/or throat passages and allow air to pass more freely. Today, there are many surgical options available to OSA sufferers, and each has its own set of benefits and disadvantages. The right type of sleep apnea surgery will be decided upon in consultation with your doctors. Whatever type of surgery is selected, you are likely to experience relief from your sleep apnea.Types of Sleep Apnea SurgeryThe most successful type of sleep apnea surgery is known as Maxillomandibular Advancement (MMA). Since the upper and lower jaws form the entrance to the throat, by moving both jaws forward, doctors can effectively expand the airway. While an extremely effective sleep apnea treatment, MMA surgery is very invasive and requires several hours of surgery and weeks of recuperation time. It is usually performed after other less invasive types of surgery have already been tried and failed or for more severe cases of OSA.Another sleep apnea surgery known as UPPP, or uvulopalatopharyngoplasty, involves the removal of soft tissue from the palate and the back of the throat. The areas that may be removed may include the uvula, the tissue behind the soft palate, and also the tonsils if they are still present. This type of sleep apnea surgery is performed to enlarge the opening of the airway in the throat. Uvulopalatopharyngoplasty can be a very painful procedure but it does have reported success rates of approximately 65%. Possible complications include infection, impaired soft palate function, mucus accumulation, and swallowing difficulties.An Uvulopalatal Flap is a similar surgical procedure to the UPPP but less tissue is removed. As with the UPPP, it involves removal of some soft palate tissue as well as the tonsils. Bleeding and throat pain are common as is overnight post operative hospitalization.Pharyngoplasty surgery removes even less tissue. A small amount of soft tissue including the tonsils is removed and other soft tissue is lifted out of the way with sutures to create a larger airway. While less painful than UPPP, post operative throat pain is common.Maxillomandibular Expansion is another surgery that involves widening narrow jaws. Less invasive than MMA, recovery time is also quicker. Overnight hospitalization is often required and recovery usually takes a few weeks.Genioglossus Advancement is a type of surgery that involves moving the tongue forward to open the airway. During surgery, the small bony projection that the tongue is attached to is moved forward. This position prevent the tongue from collapsing into the throat at night and closing the airway. Surgery lasts 30-60 minutes and recovery time is one to two weeks.Alternative Forms of Sleep Apnea SurgeryA variant of the UPPP known as LAUP, or laser-assisted uvulopalatoplasty surgery mainly eliminates snoring episodes in people. It is a simple surgical procedure that only involves the
simple removal of a small amount of tissue in the back of the throat in order to terminate long term snoring. Although this type of surgery can almost eliminate snoring, many doctors are worried that with the absence of snoring, patients with more serious forms of OSA might go undiagnosed since snoring is a major indicator of this sleep disorder. Side effects for this surgery include complications like throat dryness, throat narrowing and also throat scarring.Constricted or blocked nasal passages can also contribute to OSA. Nasal Surgery to alleviate a deviated septum or enlarge the nasal passages can also effectively treat mild cases of OSA. It can also help patients utilize CPAP machines more effectively. Recovery time from this type of sleep apnea surgery is usually just a few days.A relatively new sleep apnea surgery procedure for treating OSA is called Radiofrequency. Excess soft tissue can be precisely targeted with a probe that emits radiofrequency waves. The tissue is heated by the probe to between 140-190 degrees Fahrenheit with minimal discomfort for the patient. As healing occurs over the next few weeks, the treated tissue forms scars and shrinks thereby increasing the size of the air passages. Tissue from the tongue, soft palate and nasal passages can be treated.Another type of sleep apnea surgery is the pillar palatal implant, which is a rather non-invasive surgical procedure intended for mild to moderate cases of OSA. Just like LAUP, the procedure is directed at reducing snoring episodes, which is made possible by surgically implanting small polyester posts that muff the vibrations of the soft palate. To secure the implants, three strings of polyester are surgically sutured into the soft palate. It is a quick surgery that only takes about ten minutes, ensuring a quick recovery.Although not commonly thought of as a form of sleep apnea surgery, bariatric surgery to help obese people lose weight can also be used to treat OSA. OSA is often a side effect of obesity. Overweight people usually have excess tissue in their throat and neck that can collapse and block their airways so weight loss in commonly prescribed to alleviate the problem.Many years ago, a tracheotomy, or an opening made through the lower part of the neck into the windpipe, thereby bypassing the blocked airways, was one of the few sleep apnea surgery options for people with OSA. But, due to the problems and risks involved it is not usually a practical choice anymore. This procedure is only indicated if the OSA concerned is life-threatening; therefore it is not advisable for people with mild or moderate cases.It is estimated that as many as 50% or more of sleep apnea sufferers have difficulty with or can't use sleep apnea CPAP treatment. Fortunately, there are many oral sleep apnea devices on the market that are proving effective as well. Although generally considered the treatment of last resort, there are also many surgical options that promise long term, permanent relief for your sleep apnea symptoms. If you have OSA, talk with your doctor or sleep specialist and see if you are a candidate for sleep apnea surgery.
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