Surgical Treatment Options

Surgery Can Correct Sleep Apnea, Snoring and Other Sleep Issues

The Sleep Surgery Center at University Hospitals offers a variety of surgical treatment options for snoring and obstructive sleep apnea. In many cases, these therapies can correct problems in the airways that cause these conditions.

Surgical Treatment for Snoring

While snoring alone is not considered a health risk, it often interferes with interpersonal relationships and marriages. Snoring is caused by throat tissue vibration. Opening the nasal passage or correcting a deviated septum and removing excessive tissue such as adenoids or tonsils can often help. In some cases, shortening (palatoplasty) or stiffening (radiofrequency therapy) of the soft palate may be considered to improve snoring.

Surgical Treatment of Obstructive Sleep Apnea

Over 50 percent of patients are not able to tolerate or adhere to continuous positive airway pressure (CPAP). These patients should consider an evaluation by a sleep surgeon. As part of the evaluation, tests may be conducted to help determine the best type of surgery for each individual patient.

Drug-Induced Sleep Endoscopy (DISE)

Sleep surgery is usually preceded by a drug-induced sleep endoscopy (DISE). A sleep-like state with apnea episodes developing will be induced in the patient through medication. The physician will then examine the inside of the patient’s throat from the in order to determine the cause of the throat obstruction. This brief endoscopic procedure helps to determine which of the many available sleep surgeries will benefit the patient most.

Types of Surgery for Obstructive Sleep Apnea

The following surgeries are commonly performed:

Soft Tissue Throat Surgery

  • Palatal surgery: Depending on the type of soft palate obstruction (e.g. front to back, side to side, concentric), a specific procedure will be chosen to open the obstruction in the appropriate direction. Different palatal surgeries with modifications are available.
  • Hyoid suspension: This procedure addresses lower throat obstruction by advancing a small neck bone (hyoid bone) forward suspending it to the front of the lower jaw. The hyoid suspension expands and stabilizes the airway during sleep, making obstruction less likely to occur.
  • Base of tongue resection: Patients with either a large base of tongue (very back part of tongue) or a large lingual tonsil (different tonsil than what we usually refer as tonsil) can benefit from resection or ablation of the excess tissue. This procedure is done through the mouth.

Inspire Therapy

Inspire therapy consists of a pacemaker like device, which stabilizes tongue and throat tissue via breathing synchronized stimulation of the hypoglossal nerve, or tongue nerve. Implantation of this device is less invasive than other surgical options and the stimulation is tolerated very well by most patients. Studies have shown that two out of three patients with this therapy experienced significant improvement of their obstructive sleep apnea and snoring.

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