Surgical Alternatives for Sleep Disorders

Snoring can be an embarrassing, disruptive, and dangerous problem. It may be a sign of a disorder called sleep apnea. This issue can affect your health and the lives of others. It is estimated that over 18 million Americans have sleep apnea. Continuous positive airway pressure therapy (CPAP) is the treatment plan for many; however, patients may not choose to pursue CPAP therapy as their solution to obstructive sleep apnea. The reasons include insurance coverage, face or nose structural incompatibility, or personal preference. Some patients may benefit from treatment approaches such as surgery. Currently, there are a variety of surgical approaches that may address snoring and obstructive sleep apnea. Consulting with your primary care, sleep physician, or otolaryngologist can determine the appropriate interventions associated with your obstructive sleep apnea.

Surgical Strategies

• Uvulopalatopharyngoplasty (UPPP or UP3) - Enlarges the airway by removing or shortening the uvula, removing the tonsils, removing the adenoids, and removing part of the soft palate or roof of the mouth.
• Laser-assisted uvulopalatoplasty (LAUP) - This is a modification of the UPPP where the uvula is cut with a laser for the treatment of snoring.
• Tracheotomy - A surgical procedure that creates a hole in the trachea or windpipe below the area obstructions. Though it is the most effective surgery for OSA, it is also the least desirable.
• Midline glossectomy and the llingualplasty are laser surgeries where the tongue is thinned.
• Maxillomandibular osteotomy (MMO) or maxillomandibular advancement (MMA) - Enlarge the airway by moving the jaw forward.
• Other surgical interventions include: sagittal mandibular osteotomy and genioglossal advancement with hyoid myotomy (GAHM). These surgeries are long and involved with a significant recovery period and potential complications. Though the success rate is high, they are not often chosen treatments.