Surgery may be used to help someone with obstructive sleep apnea. The most common options reduce or eliminate the tissue in your throat. This tissue collapses and blocks your airway during sleep.
These surgeries focus on one or more of the following three areas:
- The soft palate
- The uvula, tonsils and adenoids
- The tongue
More complex surgery can be performed to adjust other bone structures. These include the mouth, nose and facial bones.
Surgical procedures that may be used to treat obstructive sleep apnea include:
- Maxillomandibular osteotomy (MMO) and advancement (MMA)
Cuts are made into the bones of the jaw. The upper and lower jaws are pulled forward and soft tissue is tightened. This enlarges the entire upper airway. An overnight hospital stay is required. The jaws may be wired shut for several weeks.
- Anterior Inferior Mandibular osteotomy (AIMO) with hyoid suspension
The chin bone is divided to pull forward the tongue. The hyoid bone (U-shaped bone in the back of the neck) is also adjusted. The jaws do not have to be wired shut, and there is no change in bite. It is not as effective as MMA.
- Uvulopalatopharyngoplasty (UPPP)
The soft palate is trimmed down in size. The tonsils and uvula may also be removed.
- Laser-assisted uvuloplasty (LAUP)
Cuts are made to scar and tighten the soft palate. The uvula is trimmed over a period of several visits. It is not as effective as UPPP and is usually done for snoring, not sleep apnea. It is less painful and has fewer side effects than UPPP.
- Radiofrequency Volumetric Tissue Reduction (RFVTR)
This may also be called somnoplasty. Energy waves are used to shrink the soft palate and tongue base. This energy is much like a microwave.
- Laser midline glossectomy (LMG) and lingualplasty:
These two procedures are rarely performed. They enlarge the airway by removing part of the back half of the tongue.
- Septoplasty and Turbinate Reduction
Both of these options are used to open the nasal passage. Septoplasty straightens a bent septum that is blocking the flow of air. The septum is the bony divider between the two nostrils.
Turbinate reduction reduces or removes large turbinates and polyps. Turbinates are curved bones along the wall of the nasal passage. Polyps are growths of tissue that stick out from the mucous lining of the nose.
- Tracheostomy
An opening is cut into the windpipe in your neck. A hollow tube is inserted to keep the hole open. The patient breathes through the tube. This bypasses the entire upper airway. It is the most effective procedure. But, it is also the most drastic. It is rarely used to treat obstructive sleep apnea. It is only used in emergency situations.
- Cervicofacial liposuction
Extra fatty tissue is removed below the chin and at the back of the neck. This reduces the weight pressing against the soft tissue of the throat. It also helps lessen airway collapse behind the base of the tongue.
- Gastric bypass
This form of bariatric surgery may be used as a last resort for people who cannot overcome obesity. It reduces the size of the stomach. This forces the patient to eat less.
