Surgery may be considered if other treatments do not help. The goal of treatment is to remove or shift excess tissue in the airway. Surgical options include:
- Tonsillectomy for enlarged tonsils
- Removal of nasal polyps
- Surgery to straighten a deviated septum
- Correction of facial or jaw deformities
- Removal of tissue in the throat
- Palate implants
Success from the surgery can be different for person to person. Any surgery also has a chance of complications. You and your doctor will talk about risks and benefits of surgery for you. Some surgical options include:
Uvulopalatopharyngoplasty (UPPP)
UPPP will remove extra tissue from the back of the throat. This includes the tonsils and part of the soft palate.
Laser-assisted Uvulopalatoplasty (LAUP)
LAUP also removes extra tissue in the back of the throat. It is done with lasers. LAUP seems to help improve snoring. It’s not clear what effect it may have on sleep apnea.
Radiofrequency Ablation
Extra tissue at the base of the tongue is removed. A tool uses radio waves to destroy tissue. It is done over a number of treatments. Snoring and decreased daytime sleepiness may decrease after ten treatments. It is more effective for snoring. It is not clear if it is effective as a treatment of sleep apnea.
Tracheostomy
Tracheostomy is a surgery that creates a new airway. An opening is made in the base of the throat. A tube will allow air to pass through this hole and into the lungs. It will bypass tissue in the back of the mouth and throat which causes the problem. This may be needed for severe apnea.
Pillar Palatal Implants
Implants can help to stiffen tissue at the back of the mouth. This may help keep tissue from falling into airway. It may be more effective for treating snoring than sleep apnea. It may help to reduce daytime sleepiness in those with sleep apnea.
References
How is sleep apnea treated? National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/sleepapnea/treatment. Accessed January 16, 2019.
Obstructive sleep apnea (OSA). EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115600/Obstructive-sleep-apnea-OSA . Updated November 28, 2018. Accessed January 16, 2019.
Position statement: surgical management of obstructive sleep apnea. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/content/surgical-management-obstructive-sleep-apnea. Accessed January 16, 2019.
12/20/2017 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T115123/Central-sleep-apnea : Costanzo MR, Ponikowski P, Javaheri S. Transvenous neurostimulation for central sleep apnoea: a randomised controlled trial. Lancet. 2016;388(10048):974-982.