Surgical Options for Sleep Apnea

The first alternative sleep apnea treatment I will address is surgery.  Currently there are 7 different surgery options available to treat sleep apnea:  genioglossus advancement, maxillomandibular advancement, maxillomandibular expansion, pharyngoplasty, uvulopalatal flap, radiofrequency, and nasal surgery.  Pictures of each of these procedures can be viewed at www.sleepapneasurgery.com.  I recommend looking at the pictures before you decide to go ahead with one of these surgeries.

Genioglossus advancement involves pulling the tongue forward via a cut-out of the bone of the lower jaw and keeping it in that position permanently.  Pulling the tongue forward should prevent it from falling into and blocking the airway while the person is asleep.  Speech and swallowing are not affected.  However, side effects do include pain and swelling, and intermittent numbness of the front teeth of the lower jaw.  This procedure may also change the shape of the jaw to some degree.

Maxillomandibular advancement involves cutting both the upper and lower jaws and moving the bones forward to enlarge the airway.  Plates, screws, braces and rubber bands are used to keep the jaws in their new positions and keep the teeth properly aligned.  The patient is not able to chew for 4 weeks after the surgery.  The facial profile will change with this procedure.

Since many people with obstructive sleep apnea have narrow jaws, a procedure called maxillomandibular expansion was developed.  This surgery involves cutting the jaw bone and orthodontic treatment is required to reposition the teeth.  There will be a change in the facial profile, although speech and swallowing are not affected.

While all of the surgeries mentioned above have their place in the treatment of sleep apnea when the airway is affected by jaw structure and the tongue, there can be undesirable side-effects and sleep apnea is not always eliminated.  Doing your own research prior to a physician consultation is recommended.  Then ask as many questions as possible and maybe even get a second opinion before consenting to go under the knife.

The pharyngoplasty and uvulopalatal flap are concerned with the soft tissues of the throat/airway only.  Pharyngoplasty usually includes tonsillectomy and airway expansion by use of sutures.  A tonsillectomy is also performed with the uvulopalatal flap.  The uvulopalatal flap is a soft palate lift which expands the airway.  While these procedures are less invasive than those that involve the jaw, recovery can be painful and the result is often ineffective in eliminating sleep apnea.

The last two surgeries, nasal surgery and radiofrequency, address problems with the nose.  It is important to understand that these surgeries are performed to eliminate nasal breathing obstruction only.  Most obstructive sleep apnea is caused by tissues and structures of the mouth and throat.  Therefore, nasal procedures often do not eliminate sleep apnea.  Nasal surgeries address nasal obstruction by reducing turbinate size, enlarging the nasal valve, or repairing a deviated septum.  Radiofrequency is used to reduce the amount of  soft tissue of the nasal turbinates when this is the cause of obstruction.  Unlike nasal surgeries, radiofrequency is also used on the soft palate and tongue.  Radiofrequency to the soft palate is only recommended for people with mild sleep apnea.

After reviewing surgical options for sleep apnea, I will stick with CPAP.  If you are having trouble adjusting to CPAP therapy and are not thrilled about surgical treatments, please call us for suggestions and help.  We promise to listen and give you our expert assistance!  877-392-7270  No strings attached!