Surgical Options May Include
- Nasal septal surgery for deviated nasal septum. The nasal septum divides the nasal cavity into two halves. A deviated septum adversely affects breathing through both halves. Correction helps with snoring and sleep apnea as well as daytime breathing. Nasal surgery may include sinus surgery for chronic sinus infection and turbinoplasty for chronic turbinate enlargement.
- UPPP (Uvulopalatopharyngoplasty) and tonsillectomy are the traditional surgical procedures for obstructive sleep apnea. Tonsillectomy is the removal of tonsils and the UPPP is a marked shortening of the soft palate with removal of redundant tissue. It is very painful, but reasonably effective in younger people whose apnea is not very severe. Insurance companies only pay for UPPP in patients who fail CPAP.
- Oral appliances are made by dentists and advance the lower jaw. They are uncomfortable and cause jaw and dental pain. Despite the discomfort, they can be relatively effective.
- CPAP (Continuous Positive Airway Pressure) is considered the Gold Standard for treatment of sleep apnea, but regular nightly use of a bulky mask and air pump is socially difficult and has poor compliance.
- Tongue procedures and maxillomandibular advancement are major head and neck procedures usually reserved for patients with skeletal abnormalities or very severe apnea who have failed other approaches.
- Tracheostomy bypasses the obstruction of the throat and is only used in the most severe of patients who fail CPAP. It may be also used in patients with other critical medical conditions allowing a safe and secure airway.