Sleep Apnea Surgery
Surgery is usually considered the last treatment option and should most certainly be when considering it for Obstructive Sleep Apnea. Most of the surgeries listed below are less successful in treating apnea then they are in controlling snoring. They are most successful in patients that have very mild OSA despite the severity of their snoring.
Uvulopalatopharyngoplasty. This procedure is best indicated in patients that have large tonsils and a long soft palate. The surgeon performs the surgery under general anesthesia in an ambulatory setting. The tonsils are excised and the soft palate shortened. The result of the surgery is to create more space behind the tongue and oral pharynx. The post-operative discomfort is extreme lasting around 10 days.
Radiofrequency Uvuopalatoplasty. This is similar to the UPPP except that it does not involve the tonsils. The surgeon uses an electrical probe to create tunnels into the soft palate. As the scaring within the tunnels form, the palate shortens and stiffens. This procedure is done when the patient does not have large tonsils and the apnea is mild. The post-operative pain is severe but less than the UPPP
Pillar Procedure. This procedure is not indicated for Obstructive Sleep Apnea. It is designed to help snorers that do not stop breathing. The surgeon places strips of non-reactive implant material into the soft palate. Since there is limited tissue injury, less soft palate retraction develops. The goals is to stiffen the palate, thereby reducing snoring. Post operatively, there is much less pain experienced.
Genioglossal Advancement. This is considered one of the more successful surgeries. It is designed to permanently suspend the tongue forward. A central portion of the mandible is cut and pulled forward, locking the attachment to the tongue in an anterior position. It is indicated in patients that have Obstructive Sleep Apnea and cannot be controlled by less aggressive means.