The Role of Surgery for Sleep Apnea
he surgical treatment of obstructive sleep apnea, historically, has had mixed results. A landmark study published in 1996 revealed that the most common surgical procedure for OSA at the time, uvulopalatopharyngoplasty (reconstructing the soft palate), had a 40% cure rate. Since that time, patient selection criteria have been developed to identify which patients would benefit most from certain surgical procedures. A “one size fits all” mentality is not appropriate for sleep apnea patients. With enhanced selection criteria, success rates have nearly doubled.
Positive airway pressure (CPAP, APAP, BiPAP, etc.) remains the gold standard treatment for obstructive sleep apnea in the absence of effective weight loss. Historically, surgeons have attempted to compete directly with CPAP therapy, but in this modern era the data does not support surgery as a first line treatment for OSA.
As surgical techniques and patient selection methods have evolved, the role of surgery has been reestablished. The contemporary approach to treating obstructive sleep apnea requires a multidisciplinary approach, relying on the expertise of sleep physicians, ENT surgeons, dentists, respiratory therapists and certified sleep technicians.
At GNO Snoring & Sinus, we have treated many patients suffering from OSA who have attempted CPAP therapy. As a result of difficulty tolerating CPAP, their doctors refer them to us for an airway evaluation and often times we discover anatomic obstructions (large tonsils, adenoids, nasal polyps, deviated septum) that are causing significant resistance to CPAP airflow. In-office or outpatient surgical treatment is provided and patients uniformly improve with regards to their breathing and ability to tolerate CPAP. In select cases, the level of sleep disturbance can return to a normal level.
Traditional surgical approaches have been associated with significant pain and prolonged recovery. We utilize such advanced procedures if the situation requires, however, we prefer to rely initially on in-office treatments for sleep apnea.
Fast, effective treatment can be obtained with little downtime using a combination of in-office radiofrequency treatments aimed at the nose, throat or tongue.
If you would like to learn more about our unique approach to treating obstructive sleep apnea, contact us for further assessment and treatment.