Obstructive sleep apnea, which is literally the stoppage of breaths during sleep, happens when there is an obstruction in the airway. Although the breath pauses normally last for 10 to 30 seconds, they happen on average 30 times an hour. The effects obstructive sleep apnea has on health put people in great danger. This is why necessary treatments, including sleep apnea surgery, have been designed to correct the obstructions in the airway, which involve the jaws, tonsils, soft palate, and tongue.
Surgical operations are normally done to treat severe sleep apnea, although a few are developed for mild to moderate cases. The severity of the case, however, dictates the degree of the invasiveness of the surgical procedure. The more severe sleep apnea is, the more invasive the surgery is.
The cause of sleep apnea is a major consideration in determining which surgery to perform. Yet, the personal preference and medical condition of the patient are also factors. Though some surgeries can stand alone as a treatment, a few are best combined with other surgical procedures in a series of treatment.
Following are only some of the sleep apnea surgical options from which surgeons, upon diagnosis and careful study of the patient's condition, choose the most appropriate and effective.
1. Uvulopalatopharyngoplasty (UPPP)
Aimed at widening and keeping the air passage open, UPPP removes the tissue from the back of the throat that might be the cause of airway obstruction. It can be some parts of the soft palate, throat tissue, tonsils and adenoids, and uvula (the soft tissue that hangs from the back of the mouth). UPPP is considered helpful in eliminating snoring, although sleep apnea may still occur after the surgical procedure. In this case, the use of continuous positive airway pressure (CPAP) is necessary. UPPP is normally recommended to people with severe obstructive sleep apnea. Patients need several weeks to recover.
2. Tracheostomy
This procedure involves making a hole in the neck to the windpipe (trachea) and inserting a tube in the opening. The tube then makes way for the free flowing of air when the patient is asleep. At daytime, the tube is closed using a valve to allow the patient to breathe and speak normally. The effectiveness of the procedure is remarkable, although it can present medical problems and emotional issues that normally involve self-image. Because of the associated risks, tracheostomy is only performed to treat severe sleep apnea or if it is the only appropriate surgery for the patient.
3. Tonsillectomy and adenoidectomy
These procedures are performed if there is an enlargement of the tonsils and adenoids. Tonsillectomy and adenoidectomy are usually the first-line of treatment among children since enlarged tonsils and adenoids are the usual causes of their sleep apnea. These procedures are also effective among adults.
4. Maxillary or maxillomandibular advancement (MMA)
In this sleep apnea surgery, the surgeon repositions the upper or lower jawbone forward. Based on the diagnosis, some surgeons choose MMA as an auxiliary or phase II operation for patients with persistent sleep apnea. In other instances, MMA is performed as the main and sole surgical operation. This is if the patient has certain medical conditions that may not benefit from multiple surgeries or if he personally chooses to undergo a single operation. Though it can significantly change the facial structure, MMA is a consistently effective treatment.
