Ear, Nose & Throat (ENT) Institute
Obstructive Sleep Apnea Surgery / CPAP Alternatives Program
Jacqueline Boni, RN Care Coordinator
Diamond Durham, Secretary
Services & Distinguishing Features
- Multidisciplinary approach: Dr. Schell is clinically trained in both ENT and Sleep Medicine, specializing in medical and surgical treatments of snoring and obstructive sleep apnea. She works closely with Pulmonology, Neurology, Dentistry, Oral Surgery, Psychology and Weight Management colleagues to formulate an individualized treatment plan for each patient.
- Upper airway stimulation surgery (INSPIRE procedure).
- Drug-induced sleep endoscopy (DISE): DISE can help determine specific airway changes during sleep, helping to guide both medical and surgical treatments.
- Nasal procedures such as septoplasty, inferior turbinate reduction, and nasal valve stabilization.
- Upper airway surgery such as tonsillectomy, modified palatoplasty (UPPP), hyoid and base of tongue procedures, and epiglottoplasty.
Which patients could benefit from a referral?
- Patients with OSA and/or snoring who would like to discuss a variety of treatment options for their symptoms. In isolation, upper airway surgery is typically most appropriate for non-obese patients without significant medical comorbidities.
- Patients with known OSA who are struggling with CPAP or BiPAP therapy. Surgery and other non-PAP therapies can often be used in combination with CPAP or BiPAP to improve efficacy and adherence.
- INSPIRE referrals: patients should have OSA that is moderate to severe (AHI 15-65) and should not be morbidly obese. Typically, BMI should be 32-35 or lower. INSPIRE is a surgical procedure associated with less morbidity and can be a good option for older patients or patients who would not otherwise tolerate traditional sleep surgery.