Surgical Therapy for Obstructive Sleep Apnea (OSA)

Obstructive sleep apnea (OSA), or simply sleep apnea, is a disorder in which an individual stops breathing for some seconds or even a minute during sleep. At times, the frequency of obstruction in breathing may occur more than 100 times during a night's sleep. Majority of the patients suffering from obstructive sleep apnea are above 35 years of age. Also men are at higher risk of developing this sleep-disorder than women. It is estimated that about 20 million Americans suffer from this syndrome.

Obstructive Sleep Apnea: Causes and Symptoms

As the name indicates, obstructive sleep apnea is caused due to obstruction of the airways. The major reasons for the occurrence of this condition remain unclear till now. In most cases, the obstruction site is observed to be the soft palate. Medical researchers opine that during sleep, the muscles of the soft palate relax, which results in extension beyond a limit, causing airway obstruction.

The symptoms of OSA generally include loud snoring, sleep disturbance and restless sleep. Treatment is necessary in order to prevent complications like congestive heart failure. Some of the treatment options include CPAP (Continuous Positive Airway Pressure), oral appliance therapy and surgery.

Obstructive Sleep Apnea: Treatment by Surgical Therapy

Surgical therapy for obstructive sleep apnea is recommended for treatment of severe OSA cases and those who do not respond to other treatment options. The main objective of surgical therapy for obstructive sleep apnea is to open airways for smooth breathing. In other terms, the main airway is altered in order to minimize the occurrence of airway obstructions. Depending upon the approach, surgical therapy for OSA can be of different types, which are discussed as follows:

Palatal Surgical Therapy: In case the causal factor of obstructive sleep apnea is a disorder in the soft palate, then the most effective treatment is palatal surgical therapy, which is a minimal invasive technique for removing part of the uvula and soft palate. This procedure is claimed to be effective in reducing snoring and other sleep- disordered breathing. However, this method is not effective for those patients whose airway obstruction occurs beyond the soft palate.

Jaw Surgical Therapy: Another type of OSA surgery for obstructive sleep apnea is jaw surgical therapy. This method is conducted on individuals having a maxillomandibular jaw structure that aggravates airway obstruction. Prior to the procedure, imaging tests of the jaw, skull and airways are performed. With the help of these images, the surgeon corrects the position of the jaws to prevent airway obstruction. In a report published on OSA, this surgical therapy is said to be effective for the treatment of more than 85 patients with sleep- disordered breathing.

Tracheotomy: For patients with life-threatening conditions, tracheotomy may be considered for treatment of obstructive sleep apnea. In this OSA surgery, a small flexible tube is inserted in the neck portion by making a small incision. While sleeping, this tube serves as a breathing aid to exchange air with the lungs by bypassing the blocked airways. There are several long-term complications of tracheotomy though, some of which include speech problems and lung infections. Hence, one should always gather adequate tracheotomy information regarding the pros and cons before opting for this surgical therapy.

For effective management of symptoms and for long-term treatment, in addition to OSA surgery, the physician may recommend alternative treatments such as controlling weight, breathing exercises, modification of sleeping position and adopting healthy lifestyle changes.