Surgical Procedures for Sleep Apnea
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If problems are identified that may be contributing to sleep apnea, and if the continuous positive airway pressure (CPAP) treatment fails, it may be beneficial to have surgery. These may include:
- Tonsillectomy (for enlarged tonsils)
- Removal of nasal polyps
- Surgery to straighten a deviated septum
- Correction of facial or jaw deformities
- Removal of tissue in the throat (uvulopalatopharyngoplasty)
The following surgeries are specialized procedures used to treat problems that may be contributing to sleep apnea. Each has variable success rates, with the potential for surgical complications.
Uvulopalatopharyngoplasty (UPPP)
This procedure involves the removal of extra tissue from the back of the throat, including the tonsils, the uvula, and part of the soft palate.
Laser-assisted Uvulopalatoplasty (LAUP)
Although this procedure seems to help improve snoring, it’s not clear whether it also has an effect on sleep apnea. This procedure uses laser techniques to remove tissue from the back of the throat.
Radiofrequency Ablation
This is another procedure that improves snoring and may have some benefits for treating sleep apnea. An electrode that emits radio waves is used to destroy some tissue at the base of the tongue. Most people have noticed decreased snoring and decreased daytime sleepiness after ten 20-minute treatments. This is more effective for snoring but has not been shown to be effective in treatment of sleep apnea.
Tracheostomy
This procedure is very rarely performed and reserved for extremely severe cases of sleep apnea. It involves creating a hole (stoma) at the base of the neck and into the trachea (windpipe). A tube in the stoma can be plugged during the day so that you can breathe and talk normally. At night, the tube is unplugged, and you breathe through the stoma.
Nasal Surgery
Nasal surgery to remove an obstruction can serve as another way to relieve sleep apnea.
References:
Being evaluated for sleep apnea. American Sleep Apnea Association website. Available at: http://www.sleepapnea.org/resources/pubs/evaluated.html . Published May 2005. Accessed September 17, 2008.
Cecil R, Goldman L, Benett JC. Cecil Textbook of Medicine. 21st ed. Philadelphia, PA: WB Saunders Company; 2000.
NINDS sleep apnea information page. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/sleep_apnea/sleep_apnea.htm . Updated June 2008. Accessed September 17, 2008.
Surgical management of obstructive sleep apnea. American Academy of Otolaryngology-Head and Neck Surgery website. Available at: http://www.entnet.org/Practice/policySurgicalMgmtApnea.cfm . Accessed September 17, 2008.
What is sleep apnea? National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/dci/Diseases/SleepApnea/SleepApnea_WhatIs.html . Updated February 2008. Accessed September 17, 2008.
Last reviewed August 2008 by Elie Edmond Rebeiz, MD, FACS
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