What Is Sleep Apnea Surgery?
Sleep apnea is a condition in which a person repeatedly stops or nearly stops breathing while they sleep. Treatment for sleep apnea depends on the type of condition diagnosed, the sleeper's medical history, and the severity of their symptoms. The most common form of sleep apnea, called obstructive sleep apnea (OSA), occurs when a person's airway collapses during sleep.
Treatment for OSA often begins with lifestyle changes and positive airway pressure (PAP) therapy. When these treatments aren't enough, a doctor may recommend alternative treatments such as oral appliances or surgery. Central sleep apnea (CSA) is a less common form of sleep apnea that happens when the brain doesn't properly signal the body to breathe. Treatment for CSA targets the underlying medical cause of the condition. Treatment may also include therapies that assist breathing using PAP therapy, supplemental oxygen, medication, or surgery.
If you've been diagnosed with sleep apnea, you may want to know if surgery is an option for you. We cover several types of surgery used to treat sleep apnea and how each procedure helps to reduce nighttime breathing disruptions.
Mouth and Throat Surgery
The most common surgeries for OSA focus on addressing physical features in the mouth and throat that contribute to a narrowed or collapsed airway.
Uvulopalatopharyngoplasty (UPPP)
The most common surgery for OSA is uvulopalatopharyngoplasty. The purpose of UPPP is to keep the airway from collapsing during sleep by addressing obstructions within the upper portion of the throat, including the uvula (a small tissue flap at the back of the throat), tonsils, and a group of muscles in the roof of the mouth called the soft palate. Most people see an improvement in snoring after UPPP and about 50% experience a significant reduction in breathing issues during sleep, though a complete cure for OSA is uncommon with this procedure.
Pharyngoplasty
Pharyngoplasty describes several variants of UPPP that target specific areas of the throat that may be contributing to OSA.
- Lateral pharyngoplasty: A lateral pharyngoplasty is a surgery that involves removing small portions of tissue from the sides of the throat. This procedure is used to reduce excess tissue from the sides of the throat that can lead to airway collapse and narrowing.
- Medial pharyngoplasty: This branch of pharyngoplasty involves removing a small portion of tissue from the cartilage wall in the middle of the throat. Medial pharyngoplasty aims to reduce tissue that restricts the opening of the airway.
- Endoscopic laser-assisted uvuloplasty (LAUP): LAUP is sometimes used to reduce or shorten the size of the uvula, tonsils, or the soft palate. During LAUP, a small fiber-optic tube with a surgical tool attaches to an endoscope. Heat from the laser shrinks and softens the tissue in the uvula and soft palate, making it less likely to collapse during sleep.
- Tonsillectomy: Tonsillectomy is the removal of the tonsils. It can be an effective procedure for treating OSA in children and is sometimes recommended in adults.
Jaw Realignment Surgery
Some forms of surgery are used to enhance and develop the jaw to open up the airway. These surgeries make changes to the skeletal structure and are considered more permanent than throat or soft palate surgeries.
- Maxillomandibular advancement (MMA): MMA is an adjustable surgery. The surgeon repositions and wraps the upper and lower jaws permanently forward to open the airway. This surgery may be an option for people for whom other surgical options have failed or those with a severe form of OSA.
- Hyoid Suspension: Hyoid suspension is a surgery used to pull the hyoid bone (a bone located near the tongue) forward and up to open the airway. It isn't frequently used and may only be recommended for specific cases.
Reconstructive Surgery
Reconstructive surgery is sometimes recommended if a person has a deformity in the head or neck that is contributing to their sleep apnea.
- Rhinoplasty: If a deviated septum or other issue affecting the shape of the nose is causing a cases of OSA, reconstruction of a person's nasal septum (the wall that divides your nostrils) may help. This reconstructive surgery is called rhinoplasty.
- Tracheostomy: Tracheostomy is an intensive surgery that's used rarely and only applies to the most severe cases when other forms of treatment are ineffective. During a tracheostomy, a hole is made in a person's neck and a tube is inserted. This tube then provides an alternative air channel to the windpipe. The person must then breathe through a tracheostomy tube rather than their nose and mouth.
If you've been diagnosed with sleep apnea and you're considering surgery, it's important to discuss all of your options with your doctor. Your doctor can help you decide which treatment is right for you and explain the risks that come along with any surgical procedure.
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