Sleep Apnea: Less Common Surgeries

Topic Overview

The first treatment options for obstructive sleep apnea (OSA) are lifestyle changes, such as losing weight or not drinking alcohol before bed, and continuous positive airway pressure (CPAP). If these do not work, or if an obvious tissue or bone problem is causing your sleep apnea, surgery is an option.

Common surgeries for sleep apnea include uvulopalatopharyngoplasty (UPPP), which is removal of excess tissue from the throat. Other common surgeries are tonsillectomy and adenoidectomy, which are removal of the tonsils and/or the adenoids.

You may consider the following surgeries if a specific bone or tissue problem is causing your sleep apnea.

• Nasal septoplasty. Nasal septoplasty repairs and straightens the bone and tissues (septum) that separate the two passages in the nose. You may have this surgery if a deformity in your nose affects your breathing.
• Nasal polypectomy. Nasal polypectomy removes soft, round growths (polyps) that can project into the nasal passages and block airflow.

Several procedures have been developed to correct bony deformities of the mouth and throat that can cause sleep apnea. They include:

• Adjustments in the jaw, facial structure, or both.
• Removal of part of the tongue (glossectomy) along with structures in the throat.
• Jaw advancement (for life-threatening situations only, when other treatments have failed).

A procedure has been developed to prevent the tongue from collapsing into the airway. The surgery, called tongue suspension, involves placing a small screw in the front of the jaw. Surgical thread is looped through the base of the tongue and attached to the screw. The long-term effectiveness of this procedure is not yet known.

In another surgery, a device is implanted in the upper chest. It senses the breathing pattern and mildly stimulates the nerves of the airway muscles. This helps keep the airway open.