21 doctors weighed in:

I'm suffering from obstructive sleep apnea, what are the available surgical solutions?

21 doctors weighed in
Dr. Patrick Melder
ENT - Head & Neck Surgery
7 doctors agree

In brief: Many

I usually break the airway down into thirds when i evaluate a patient with osa.
If indicated, surgical correction/reconstruction is as follows: 1) nose: septoplasty and turbinate reduction 2) oral: uppp (sparing uvula) - if the surgeon doesn't discuss saving the uvula - see someone else; tonsillectomy 3) hypopharynx: midline glossectomy; hyoid suspension. Mandibular advancement is also an option.

In brief: Many

I usually break the airway down into thirds when i evaluate a patient with osa.
If indicated, surgical correction/reconstruction is as follows: 1) nose: septoplasty and turbinate reduction 2) oral: uppp (sparing uvula) - if the surgeon doesn't discuss saving the uvula - see someone else; tonsillectomy 3) hypopharynx: midline glossectomy; hyoid suspension. Mandibular advancement is also an option.
Dr. Patrick Melder
Dr. Patrick Melder
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Dr. Paige Gutheil
Family Medicine
7 doctors agree

In brief: Oropharyngeal

The most common procedure is one in which the soft tissues of the palate are partially removed.
An ear, nose and throat surgeon "trims" the uvula that hangs from the top of the palate and some of the surrounding tissues. Tonsils and adenoids are typically removed as well. Recovery is somewhat painful, but for many the one-time recovery is a good alternative to CPAP machines.

In brief: Oropharyngeal

The most common procedure is one in which the soft tissues of the palate are partially removed.
An ear, nose and throat surgeon "trims" the uvula that hangs from the top of the palate and some of the surrounding tissues. Tonsils and adenoids are typically removed as well. Recovery is somewhat painful, but for many the one-time recovery is a good alternative to CPAP machines.
Dr. Paige Gutheil
Dr. Paige Gutheil
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Dr. Ofer Jacobowitz
ENT - Head & Neck Surgery
6 doctors agree

In brief: Multiple

Surgery is a good option for CPAP intolerance.
It is reconstructive and should be tailored to your specific anatomy. Sleep endoscopy is advised prior. Upper pharyngeal surgery includes lateral pharyngoplasty and palatal advancement and preferably uvula-sparing uppp. Lower surgery includes tongue surgery or glossectomy, genioglossus advancement, hyoid suspension and jaw advancement. Find an expert.

In brief: Multiple

Surgery is a good option for CPAP intolerance.
It is reconstructive and should be tailored to your specific anatomy. Sleep endoscopy is advised prior. Upper pharyngeal surgery includes lateral pharyngoplasty and palatal advancement and preferably uvula-sparing uppp. Lower surgery includes tongue surgery or glossectomy, genioglossus advancement, hyoid suspension and jaw advancement. Find an expert.
Dr. Ofer Jacobowitz
Dr. Ofer Jacobowitz
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1 comment
Dr. Patrick Melder
Agree about uvula. If you have this surgery, make sure your surgeon preserves the uvula. It serves an important function (swallowing, mucous production, speech). The classic UPPP can actually create scarring that makes the apnea worse.
Dr. Patrick Melder
ENT - Head & Neck Surgery
6 doctors agree

In brief: Surgery is an option

I counsel all my patients that CPAP is the first option.
If patients don't tolerate (high pressures, claustrophobia, etc) then you should seek a surgical opinion. I also talk to all my patients about weight loss. Mandibular advancement devices are also an option. If you are not tolerating CPAP you do need to be treated: entassociatesofnorthgeorgia.Com.

In brief: Surgery is an option

I counsel all my patients that CPAP is the first option.
If patients don't tolerate (high pressures, claustrophobia, etc) then you should seek a surgical opinion. I also talk to all my patients about weight loss. Mandibular advancement devices are also an option. If you are not tolerating CPAP you do need to be treated: entassociatesofnorthgeorgia.Com.
Dr. Patrick Melder
Dr. Patrick Melder
Thank
Dr. Allen Fein
Family Medicine
4 doctors agree

In brief: Think Non surgical!

As a physician who has osa (obstructive sleep apnea), I have heard form local specialists that surgery is not recommended.
Weight loss is, but does not adequately resolve the need to use cpap. Training in using the digeridoo (australian wind instrument) helps according to reports. Osa is a serious condition that is best addressed quickly, as with delay, the reversible benefits are lessened.

In brief: Think Non surgical!

As a physician who has osa (obstructive sleep apnea), I have heard form local specialists that surgery is not recommended.
Weight loss is, but does not adequately resolve the need to use cpap. Training in using the digeridoo (australian wind instrument) helps according to reports. Osa is a serious condition that is best addressed quickly, as with delay, the reversible benefits are lessened.
Dr. Allen Fein
Dr. Allen Fein
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1 comment
Dr. Ofer Jacobowitz
Surgery is recommended when performed by expert. For adults, unless there are very large tonsils, non-surgical treatment comes first. The Problem is that so many patients give up on cpap, weight loss and are left untreated. Surgery is thus very important to help these patients. Digeridoo playing and oral exercises for OSA are very interesting but only have a mild effect.
Dr. Jason Hall
Surgery - Plastics
2 doctors agree

In brief: Numerous

CPAP and weight loss are usually the first solutions recommended.
However, anatomic abnormalities with the airways (such as a small or a "floppy" upper airway) are temporized by these treatments and not corrected. In this group of patients, jaw surgery can be curative or, at the very least, severely reduce the symptoms of osa. Consultation with an expert in osa is recommended.

In brief: Numerous

CPAP and weight loss are usually the first solutions recommended.
However, anatomic abnormalities with the airways (such as a small or a "floppy" upper airway) are temporized by these treatments and not corrected. In this group of patients, jaw surgery can be curative or, at the very least, severely reduce the symptoms of osa. Consultation with an expert in osa is recommended.
Dr. Jason Hall
Dr. Jason Hall
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2 comments
Dr. Ofer Jacobowitz
Major jaw surgery can be effective in treating OSA but most data is for young, non-obese patients. It is rarely accepted and has very long recovery. When performed by expert, soft tissue surgery targeted to specific patient features can be very effective and is not temporizing. Surgery will usually improve the OSA status but does not resolve it completely (neither do many medical treatments)
Dr. Brian Dorfman
Actually Orthognathic surgery (maxillomandibular advancement) has documented 95% success rates in all populations include obese. Recovery is not very long at all. About 2-3 weeks, but very little pain which is not the case for soft tissue surgery. It also has no relapse as there is seen with soft tissue surgery.
Dr. Mark Loury
ENT - Head & Neck Surgery

In brief: Surgery last option

Uppp cures osas only 40% of the time so is not recommended as isolated procedure.
If the tonsils are massive and tongue is small then uppp/t and a can cure in 80% if bmi<40. Small tonsils and large tongue is much less likely to improve with surgery. Usually osas surgery reserved for CPAP or mandibular advancement device failures. If u don't have osas and only snore then uppp helps snore in >80%.

In brief: Surgery last option

Uppp cures osas only 40% of the time so is not recommended as isolated procedure.
If the tonsils are massive and tongue is small then uppp/t and a can cure in 80% if bmi<40. Small tonsils and large tongue is much less likely to improve with surgery. Usually osas surgery reserved for CPAP or mandibular advancement device failures. If u don't have osas and only snore then uppp helps snore in >80%.
Dr. Mark Loury
Dr. Mark Loury
Thank
Dr. Glenn MacFarlane
Dentistry - Cosmetic

In brief: SURGERY LAST RESORT

All none evasive treatment option must be explored before any surgery should be performed to treat sleep apnea.
Cpap, or better yet, oral appliances, ate the best treatments to consider. If there is tissue interference in your throat area (large tonsil or uvula, phyringeal walls, etc) then surgery may be needed but it may not stop the apnea. Consult with a dentist as well as the surgeon to get the best results.

In brief: SURGERY LAST RESORT

All none evasive treatment option must be explored before any surgery should be performed to treat sleep apnea.
Cpap, or better yet, oral appliances, ate the best treatments to consider. If there is tissue interference in your throat area (large tonsil or uvula, phyringeal walls, etc) then surgery may be needed but it may not stop the apnea. Consult with a dentist as well as the surgeon to get the best results.
Dr. Glenn MacFarlane
Dr. Glenn MacFarlane
Thank
Dr. Brian Dorfman
Surgery - Oral & Maxillofacial

In brief: MMA

Maxillomandibular advancement (orthognathic surgery) has the greatest documented success rate out of any surgical procedures available (besides a tracheostomy).
Maxillomandibular advancement has a documented success rate of 95 %. It addresses all possible levels of obstruction with minimal discomfort and down time. More importantly, no possibility of relapse as with most other procedures.

In brief: MMA

Maxillomandibular advancement (orthognathic surgery) has the greatest documented success rate out of any surgical procedures available (besides a tracheostomy).
Maxillomandibular advancement has a documented success rate of 95 %. It addresses all possible levels of obstruction with minimal discomfort and down time. More importantly, no possibility of relapse as with most other procedures.
Dr. Brian Dorfman
Dr. Brian Dorfman
Thank

In brief: Maybe wt loss

The majority of patients with osa are obese.
If you are, wt loss will frequently improve or cure the disease. This is one of the areas where bariatric (wt loss) surgery is helpful. Some patients both obese and not will require surgery on the palate and throat, but since the majority of patients are obese, the first surgical option should many times be wt loss surgery.

In brief: Maybe wt loss

The majority of patients with osa are obese.
If you are, wt loss will frequently improve or cure the disease. This is one of the areas where bariatric (wt loss) surgery is helpful. Some patients both obese and not will require surgery on the palate and throat, but since the majority of patients are obese, the first surgical option should many times be wt loss surgery.
Dr. Phillip Price
Dr. Phillip Price
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