Sleep Apnea Surgery
Sleep apnea (apnea from the
Greek, meaning “without breath”) is a sleep disorder characterized by frequent pauses in breathing during sleep. There are three types of sleep apnea, obstructive, central and mixed. Obstructive is the most common, and is caused by anatomical blockage of the airway, and as such can often be
treated by sleep apnea surgery.
Sleep apnea surgery for obstructive sleep apnea consists of several different types of procedures:
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Uvulopalatopharyngoplasty or UPPP, is the most common sleep apnea
surgery for adults. The procedure enlarges the airway by removing or shortening the
uvula, (tissue that hangs from the roof of the mouth at the back of the throat). The
tonsils and adenoids, if present, are also removed as well as part of the soft palate (roof of the mouth).
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Tonsillectomy
and/or adenoidectomy is a sleep apnea surgery that removes the tonsils and/or the adenoids, often the first treatment option for
children because enlarged tonsils and adenoids are usually the cause of their sleep apnea.
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Tracheotomy creates
a hole in the windpipe (trachea), and a tube is placed in the hole to allow air in. This
sleep apnea surgery, the most effective, is usually
reserved for serious apnea sufferers when other treatments have failed. The site around
the tube must be cleaned daily to prevent infection.
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Septoplasy is a sleep
apnea surgery that straightens a crooked septum (the partition between the nasal cavities).
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Laser midline glossectomy
and lingualplasty are types of sleep apnea surgery that remove a portion of the tongue.
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Maxillomandibular
osteotomy or advancement (MMO or MMA) and two-part inferior sagittal mandibular osteotomy. are types of sleep apnea surgery which
help enlarge the airway by moving the mandible (jaw) forward These surgeries have high
success rates, but last several hours, have a significant recovery period, and potential complications.
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A relatively new procedure
for sleep apnea surgery, performed in the physician’s office, is radio frequency ablation (RFTA), trade name
SomnoplastyTM. Approved by the Food and Drug Administration (FDA) in 1998, it shrinks
the size of the tongue and/ or palate. Multiple treatments may be required, and can be
used along with other sleep apnea treatments.
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The tongue suspension procedure
(trade name Repose) is a different sleep apnea surgery procedure. Approved by the FDA in
February 1998, this sleep apnea surgery is intended to keep the tongue from falling back over the airway by inserting a small screw
into the lower jaw bone and stitches below the tongue. Usually performed in conjunction
with other procedures, this surgery is potentially reversible. No studies, however, on
the long-term success are available, and little clinical data have been published to demonstrate the procedure’s effectiveness.
When considering sleep apnea surgery, be aware that effectiveness varies from person to person. Physicians who perform sleep apnea surgery are most commonly otolaryngologists (specializing in the ears,
nose, and throat) and oral and maxillofacial surgeons. Referrals to a surgeon may be obtained
through your family physician or through a sleep center.
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