What You Need to Know About Surgery for Snoring and Sleep Apnea
With many snoring surgical options available, it is up to the surgeon to find where the obstruction is in the patient’s upper airway or nasal passage and determine what the best solution is. Surgery is typically more effective in the treatment of snoring than for sleep apnea.
What Are My Options for Snoring Surgery?
Below are the most common snoring surgical procedures that may also help treat sleep apnea:
Uvulopalatopharyngoplasty (UPPP): This is the most common form of surgical treatment for sleep apnea. The UPPP is a surgical procedure in which tissue from the soft palate and uvula is removed. The procedure usually helps stop snoring, but only has a 40% chance of reducing sleep apnea to acceptable levels. The AASM recommends that patients try CPAP or oral appliance therapy before going forward with this procedure.
Tonsillectomy and adenoidectomy: These surgeries remove the tonsils and adenoids. If the tonsils or adenoids are enlarged, they can be a contributor in obstructive sleep apnea by blocking the airway. The removal of the tonsils and adenoids is sometimes done in conjunction with a UPPP procedure if the surgeon deems them a contributor to the airway blockage. For children, this is the main contributor of obstructive sleep apnea (OSA), and these procedures have been shown to improve or eliminate OSA in over 75% of cases. These are the most common procedures for children suffering from OSA.
Pillar Procedure: The pillar palatal implant is a minimally invasive surgical treatment for snoring and mild sleep apnea. The pillar procedure consists of placing three polyester implants into the soft palate. These implants, in time, are intended to support and stiffen the soft palate which will reduce the tissue vibration causing snoring and prevent the collapse that can lead to obstructive sleep apnea. It is much less painful than UPPP surgery. Currently there is not sufficient evidence to support the pillar procedure as an effective treatment for sleep apnea.
Somnoplasty: Somnoplasty provides a relatively painless procedure to treat habitual snoring, reducing soft-palate tissue volume in a precise minimally invasive manner. Snoring has been shown to decrease following tissue volume reduction, and recent studies have shown post-treatment pain to range from negligible to mild. Somnoplasty is an effective and minimally invasive choice for the surgical treatment of obstructive sleep apnea syndrome. Delivering radiofrequency energy submucosally to the base of tongue, Somnoplasty creates limited zones of coagulation beneath the tissue surface. As lesions resorb, they stiffen and reduce the tissue in the base of tongue. A study published for OSA reported a 55% reduction in the mean respiratory disturbance index (RDI) from baseline for all subjects with an overall mean reduction in tongue volume of 17%.
Septoplasty: This surgical procedure repairs a deviated septum. The nasal septum is the wall between the nostrils that separates the two nasal passages, and deviation occurs when the cartilage or bone in the nasal septum is not straight. A crooked septum can make breathing difficult and contribute to snoring and sleep apnea.
Genioglossus Tongue Advancement: This surgical procedure is designed to improve the airway behind the base of the tongue. The genioglossis muscle (the main tongue muscle) relaxes during sleep often allowing the tongue to fall back into the airway. The muscle attaches to the genial tubercle in the middle of the lower jaw. A segment of bone that includes the muscle attachment is pulled forward and stabilized.
Hyoid Suspension: The hyoid bone, located in the neck, is the attachment of some tongue muscles. If the hyoid bone is pulled forward surgically, it can open the airway space behind the tongue and help with snoring and sleep apnea.
Maxillomandibular Advancement: In this procedure the maxilla and mandible are advanced anteriorly and fixed in a position that maximally increases the size of the airway.Before trying surgery to stop snoring or treat sleep apnea, take a look at the other treatment options, including CPAP and oral appliance therapy.
Source 1: Obstructive sleep apnea | University of Maryland Medical Center University of Maryland Medical Center
Source 2: SleepApnea.org | http://www.sleepapnea.org/treat/treatment-options/surgery.html