Surgery

Surgery is sometimes recommended, usually by ear, nose, and throat specialists, for severe obstructive sleep apnea and snoring. It is usually not done unless other treatments have failed.

Uvulopalatopharyngoplasty (UPPP)

UPPP is the most common surgical procedure for snoring and sleep apnea. The surgeon removes most of the loose tissue of the upper airway, including the soft palate and the uvula. The initial success rate is relatively good. Effectiveness of this surgery is reduced over time. Some patients experience changes in their voice and regurgitation of liquids through their nose.

Maxillary and mandibular advancement

Maxillo-Mandibular Advancement (MMA) is a procedure where both the upper and lower jaws are surgically moved forward. Although this is one of the most aggressive surgical procedures for the treatment of sleep apnea, it is also the most successful. Most studies show successful treatment of sleep apnea in greater than 90% of cases.

Laser Surgery (LAUP)

A laser beam is used to trim the uvula and soft palate in a series of sessions. The resulting tightening of the tissue lifts the palate clear of the airway as the scars heal. LAUP requires up to five treatments spaced four to eight weeks apart (although one to three are usual). For the majority of those undergoing this procedure there will be swallowing pain similar to a severe sore throat, however the patient undergoing the procedure can expect to return to a normal routine almost immediately

Hyoid Suspension

If collapse occurs at the tongue base, a hyoid suspension may be indicated. The hyoid bone is a U-shaped bone in the neck located above the level of the thyroid cartilage (Adam’s apple) that has attachments to the muscles of the tongue as well as other muscles and soft tissues around the throat. The procedure secures the hyoid bone to the thyroid cartilage and helps to stabilize this region of the airway.

Genioglossus Advancement (GGA)

GGA was developed specifically to treat obstructive sleep apnea, and is designed to open the upper breathing passage. The procedure tightens the front tongue tendon, thereby reducing the degree of tongue displacement into the throat.

Tonsillectomy

Your doctor may suggest tonsillectomy (removal of the tonsils or adenoids, indicated in the figure) at the bottom of the page to treat sleep apnea if you have enlarged tonsils that are blocking your airway during sleep. This is often the first treatment option for children, because enlarged tonsils and adenoids are usually the cause of their sleep apnea. A very sore throat usually follows a tonsillectomy and may last for a week.

Pillar Procedure

During the Pillar Procedure, a specially trained ear, nose, and throat (ENT) doctor or other Pillar Procedure Specialist places 3 tiny woven implants (approximately 0.7 inches long and 0.08 inches wide) into the soft palate using a sterile delivery tool. Over time, the implants, together with the body’s natural fibrotic response, add structural support to stiffen the soft palate and reduce the tissue vibration that can cause snoring. The implants also help reduce the tissue collapse that can obstruct the upper airway and cause sleep apnea.

Other Surgeries

Other surgery types, if applicable, include include nasal polypectomy (removal of nasal polyps), septoplasty (corrective surgical procedure done to straighten the nasal septum, the wall separating the two nostrils), trimming of the turbinates (see figure below) and bariatric surgery (weight loss surgery, e. g. gastric bypass).