SLEEP APNEA SURGERY




sleep apnea surgery for sleep apnea treatment

Sleep apnea surgery is sometimes required to alleviate the symptoms associated with this sleep disorder that causes millions of Americans to have deprivation of sleep.

When the obstructive sleep apnea is considered a severe case, doctors (usually throat specialists) will recommend surgery for sleep apnea. My personal view on apnea surgery is this: Given that there has been little medical research performed proving that apnea surgery is a long term viable treatment for OSA, I do not believe that sleep apnea surgery is the way to go. I would get a second opinion and probably a third before going ahead and getting any type of surgery to treat sleep apnea. Please note: Success Rates. Success rates for sleep apnea surgery are rarely higher than 65% and often deteriorate with time, averaging about 50% or less over the long term.

an obstructed airway leading to sleep apnea a normal unobstructed airway

It has been shown that adults and children with obstructive sleep apnea have a smaller airway compared to individuals without obstructive sleep apnea. Since the hallmark of obstructive sleep apnea syndrome is upper airway obstruction during sleep, surgical management of the condition usually involves enlarging the airway by removal of soft tissues, or by expansion of the jaw structures that are restricting it.



Before listing the different types of sleep apnea surgeries, let’s take a look at the possible complications:

Uvulopalatopharyngoplasty is probably the most painful surgery for sleep apnea and one must be prepared to go through a recovery period of several weeks. Sleep apnea surgery is recommended only for a very select few patients that suffer from what is seen as severe obstructive sleep apnea. In addition to the long and painful recovery, this sleep apnea procedure has quite a number of known potentially serious complications. One study actually concluded that, 42% of patients had complaints about the procedure itself and most listed some if not all of the complications listed below:

  • Infection. In one study, this complication was so common that 40% of patients needed another operation because of it. Preventive antibiotics administered an hour before sleep apnea surgery can help reduce this risk.
  • Impaired function in the soft palate and muscles of the throat.
  • Mucus in the throat.
  • Changes in voice frequency (this is a pretty heavy consequence).
  • Swallowing problems.
  • Regurgitation of fluids through the nose or mouth.
  • Impaired sense of smell.
  • Failure and recurrence of apnea. VERY IMPORTANT: CPAP is often less effective afterward, although one study found that oral appliances (plastic mouth retainer-like devices) may still help.

Because the airway pattern and the severity of obstruction vary greatly between individuals, this is the main reason why the success rate of a given sleep apnea surgical procedure also varies greatly. In general, as the severity of the obstruction sleep apnea (OSA) increases, so does the invasiveness of the required sleep apnea surgery.

Listed below are the procedures that can be used to treat sleep apnea:

Tracheotomy

  • The surgeon makes an opening through the neck into the windpipe and inserts a tube.
  • It is almost 100% successful, but it requires a quarter-size opening in the throat. This produces a number of medical and psychological problems associated with recovery.

Uvulopalatopharyngoplasty (UPPP)

  • During the UPPP procedure, a surgeon removes a certain amount of soft tissue on the back of the throat and palate in order to minimize the risk of the airway collapsing during sleep.

Laser Assisted UP – LAUP

  • Increasingly performed to reduce snoring.
  • Uses a laser to remove uvula, throat and palate tissue.

Somnoplasty

  • It is used to tighten and reduce soft palate tissue.
  • It causes the tissues to essentially shrivel up.

Tongue Reduction Sleep Apnea Surgery

  • This surgery is helpful for reducing apnea but long term results are only fair and the surgery is considered radical.
  • A surgeon uses a small probe containing radio frequency energy targeted at the base of the tongue.

Tonsillectomy and Adenoidectomy

  • Removing the tonsils and adenoids, creates more space for airflow and reduces the likelihood of tissue collapse.
  • Recommended for children with sleep apnea or heavy snoring problems.

Bimaxillary Advancement

  • Involves moving the jaw forward by moving the bone. The soft tissues and muscles are pulled forward. This enlarges the airway.
  • The enlarged mouth also reduces the chance that the tongue will interfere with correct breathing.

Genioglossus and Hyoid Advancement (GGA)

  • This is a procedure that pulls the tongue muscles forward and prevents the collapse of the airway.
  • Expected result is an enlarged space between the rear of the tongue and the patient's airway.

Insurance typically covers surgery for sleep apnea, but not all surgical procedures. However, insurance companies that initially refuse to pay for a surgery may be convinced otherwise upon an appeal that demonstrates the efficacy and appropriateness of the surgery in your case.

Even as more and more people in the United States are diagnosed with obstructive sleep apnea (OSA), there remains a big debate as to who can benefit from corrective apnea surgery and, based on the possible complications and success rate the debate expands to whether or not apnia surgery is actually worth it.

Sleep apnea surgery can successfully conclude the symptoms of obstructive sleep apnea and produce freedom from CPAP, especially for mild to moderate disease severity. There are additional treatment options for OSA that do not require sleep apnea surgery, including devices to keep the airway open. As mentioned, some surgeries are performed to make using the devices more comfortable. Which treatment is right for you depends upon the severity of your OSA and other aspects of your medical condition. Talk to your doctor about what is best for you, and remember your doctor may take a step-wise approach to treatment.

deprivation of sleep | sleep apnea | what is sleep apnea | obstructive sleep apnea | central sleep apnea | mixed sleep apnea | sleep apnea symptoms | sleep apnea treatments | sleep apnea surgery