Surgery Choices
- Uvulopalatopharyngoplasty removes excess tissue in the throat to make the airway wider. It is the most common surgery to treat sleep apnea in adults.
- Tonsillectomy and/or adenoidectomy removes the tonsils and/or the adenoids. It is an option if you have enlarged tonsils and adenoids that are blocking your airway during sleep. This is often the first treatment option for children because enlarged tonsils and adenoids are usually the cause of their sleep apnea.
- Other surgical procedures are used to repair bone and tissue problems in the mouth and throat.
- Tracheostomy creates a hole in the windpipe (trachea). A tube is then put in the hole to bring air in. Doctors rarely use this surgery because it may cause other health problems. But when other techniques have failed, almost all people who are treated with tracheostomy will be cured of their sleep apnea.
- Bariatric surgery is done for weight loss. If you are extremely overweight (severely obese) and the excess weight is making your sleep apnea worse, you may consider surgery to help you lose weight. Bariatric surgery can promote weight loss that improves sleep apnea.
Surgery can successfully conclude the symptoms of obstructive sleep apnea and produce freedom from CPAP, especially for mild to moderate disease severity. The “state of the art” surgical plan for treating Obstructive Sleep Apnea (OSA) should consider all of the treatment options found in this web site. This overview is designed to help you and your physician to make a more informed decision about the role that surgery might play in the treatment of your obstructive sleep apnea. Your Ear, Nose and Throat specialist should be able to provide more detailed information and further counseling as you consider your treatment options.
In addition to the above, surgical techniques developed are also used to improve the upper airway at the three levels of possible obstruction: nose, palate & base of tongue. These are nasal reconstruction (nose), uvulopalatopharyngeoplasty (UPPP) or uvulopalatoflap (UPF), (soft palate) mandibular osteotomy with genioglossus advancement, hyoid myotomy and suspension, and maxillomandibular (Bi-maxillary) advancement (tongue base).
Surgery for children
Tonsillectomy and/or adenoidectomy usually is the first choice for children, because enlarged tonsils or adenoids cause most cases of sleep apnea in children. Other types of surgery may be needed to correct birth defects that can cause sleep apnea symptoms.
If you are thinking about having surgery to treat sleep apnea, talk with your doctor about having a sleep study done first. Experts typically suggest that you try continuous positive airway pressure (CPAP) before considering surgery. CPAP is a machine that increases air pressure in the throat and prevents tissues in the airway from collapsing when you breathe in.
In adults, uvulopalatopharyngoplasty (UPPP) is the most common surgery used to treat sleep apnea.
- There is no clear research on how well UPPP works for sleep apnea.
- UPPP may stop snoring, but apnea episodes may continue.
- Limited research shows that about 40% to 60% of people who have UPPP see an improvement in their symptoms.
- You may still need other forms of treatment, including continuous positive airway pressure (CPAP), after surgery.
- You will need sleep studies after surgery to make sure periods of apnea do not continue or return.
- UPPP usually is not used to treat sleep apnea in children.
