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Surgical approaches in obstructive sleep apnea syndrome: A review of techniques

The aim of the surgical therapies for the treatment of OSAS is to improve airway patency by operating on selected sites of obstruction. Different surgical modalities have been developed, since different anatomical locations may be responsible for a narrow upper airway. Consequently, the surgical approach needs to be individualized for each patient. Surgical treatment of OSAS presents variable efficacy but is capable of improving mortality and morbidity rates in selected patients. However, the surgery for OSAS is not a substitute for CPAP but is a salvage treatment option for patients who have failed CPAP and other conservative treatments, or had significant side effects of device use, or have…

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 Should You Consider Sleep Apnea Surgery?

There is no single surgery to treat obstructive sleep apnea. Instead, your provider will determine the cause of OSA and help you pick the procedure that’s best for you. “Children with OSA may have enlarged tonsils or adenoids that are blocking their airway,” explains Dr. Plawecki. “The majority of children (and some adults) with this issue benefit from surgical removal of the tonsils or adenoids.” In most adults, however, there are usually other issues going on, she adds. Adults with OSA may have problems with their tongue or throat muscles. If these structures are enlarged or if they aren’t sitting in the right place, they can block your airway when you sleep. That’s where OSA surgery comes in. Some people benefit from surgery to remove or reposition excess tissue in the back of the throat, known as uvulopalatopharyngoplasty (UPPP or UP3). For years, this was the primary option for sleep apnea surgery. Though it worked well for many patients, it involves a longer recovery and can’t be customized or changed once it’s done.

 The emerging option of upper airway stimulation therapy

A major determining factor of upper airway patency during sleep is the activity of the genioglossus muscle. Activation of this muscle via stimulation of the hypoglossal nerve is a creative new approach for treatment of obstructive sleep apnea (OSA). Hypoglossal nerve stimulation therapy is commonly referred to as Inspire, a reference to the name of the company — Inspire Medical Systems — that developed the treatment, which was approved by the Food and Drug Administration in 2014.

 What Happens With Minimally Invasive Sleep Apnea Surgery

In the past, the most common form of surgery for sleep apnea was very invasive, but now there are different kinds of minimally invasive surgery that can help address the causes of sleep apnea.

Articles of Interest

How To Beat Sleep Apnea? Cut It Out (Surgically)

Some patients may require surgery to remove the uvula or the tonsils or excess tissue, or all of them, she says. Then, there's surgery to remove blockage in the nasal passage. Oftentimes, Aurora says, patients need a series of surgeries to completely treat apnea. And even then, success rates aren't high; they're effective only 20 to 30 percent of the time. The only surgery proved effective more than 90 percent of the time is a significant and highly invasive surgery. Maxillomandibular advancement, or MMA, involves literally slicing the jaw in half and moving it forward in order to widen the patient's airway.

Sleep Apnea Surgery

Different surgical procedures target specific airway obstructions, such as tissues in the throat, nasal passages, or jaw position, to help reduce breathing interruptions during sleep. While some children with sleep apnea benefit from adenotonsillectomy as a first-line treatment, adults typically only undergo sleep apnea surgery after other therapies haven’t sufficiently improved symptoms.

Sleep Apnea Surgery, Snoring Surgery: Types

Sleep apnea or snoring surgeries target three main areas -- the nasal, palate, and/or tongue regions -- to reduce obstructions and widen airways. You may need intervention in more than one area.

Sleep Apnea Surgery: A New Beginning for Restful Nights

Sleep apnea surgery aims to increase the size of the airway to reduce obstructions, therefore encouraging easier and smoother breathing.

Surgery for adult patients with obstructive sleep apnoea: A review for general practitioners

There are many surgical options available for OSA and the decision on the most appropriate intervention is based on anatomical considerations. Success rates for surgery are variable and the longevity of benefit is uncertain

Surgical management of obstructive sleep apnea

This paper reviews common surgical techniques used for clinical management of OSA patients, with emphasis on jaw advancement surgical procedures.

Surgical management of obstructive sleep apnea: A collaborative approach to a multidisciplinary disease

In the evolving world of sleep medicine, emerging evidence has shown the importance of craniofacial structure and its impact on the dynamic airway. Dental professionals are uniquely positioned to not only screen and treat patients with sleep disordered breathing but also prevent the development of known risk factors that can contribute to airway instability. As the field continues to grow, so too does our understanding of this complex disease.

Surgical Therapy of Obstructive Sleep Apnea: A Review

Obstructive sleep apnea (OSA) is a disease characterized by intermittent and repetitive narrowing of the airway during sleep. Surgical therapies for the treatment of OSA aim to improve airway patency by addressing selected site(s) of obstruction. Because several areas may each be responsible for the narrowing, different surgical modalities have also been developed.

Surgical Treatment of Snoring and Obstructive Sleep Apnea Syndrome

Obstructive sleep apnea (OSA) syndrome is characterized by repetitive episodes of upper airway obstruction due to the collapse of the upper airway during sleep. For patients who have failed conservative therapy, established surgical approaches may be indicated. This evidence review addresses minimally invasive surgical procedures for the treatment of OSA.

Surgical Treatment Options for Obstructive Sleep Apnea (OSA)

When patients have limited success with conservative OSA treatments, surgeries of the nose, throat, or jaw may be recommended. Surgery may be used alone or with other treatments to achieve the best possible outcome. In general, OSA surgery has the most success when the patient’s weight is in a normal range.

Surgical Treatments for Obstructive Sleep Apnea: Updated Guidelines From the American Academy of Sleep Medicine

. Although some interventions can improve adherence, referral for surgical therapy should be considered for patients who will not accept or are intolerant of PAP therapy, who have persistent trouble adhering to PAP therapy because of pressure-related adverse effects, or who have obvious anatomic abnormalities in the upper airway.