Some sleep apnea patients may need surgery to remove excess tissue from the nose or throat (removal of adenoids and tonsils, nasal polyps or other growth) and to straighten a deviated septum. Although surgery is an excellent way of treating symptomatic sleep apnea, its success rate is low. Therefore, surgery should be reserved for those patients who have not responded to other therapeutic interventions. Usually, more than one surgical procedure is attempted to realize the benefits. Uvulopalatopharyngoplasty (UPPP) is the most common surgery to treat sleep apnea. It intends to enlarge the airways by removing all redundant tissue (tonsils, adenoids, uvula) from the pharynx. The overall success rate is 30 to 50 percent. Laser-assisted Uvulopalatoplasty (LAUP) can be performed in a specialist's office and involves the use of a laser to remove part of the soft palate, shorten the uvula (the uvula is the tissue that hangs from the middle of the back of the roof of the mouth) and remove other excess tissue from the pharynx. However, the effectiveness of LAUP in treating sleep apnea has not yet been proven. Tracheostomy is absolutely successful but is very invasive, both physically and psychologically and therefore is generally reserved for patients with severe life threatening sleep apnea. In this procedure, a small hole is made in the trachea or windpipe below the site of obstruction and a tube is inserted into the opening. This tube is opened only during sleeping hours, so that air flows directly into the lungs, bypassing any blocked air passage in the throat. Other surgical procedures include radiofrequency ablation (RFA), which makes use of radiofrequency energy to remove tissue from uvula, soft palate and tongue and thereby help treat sleep apnea. In children and adolescents removal of enlarged tonsils or adenoids stands as a viable option in the treatment of sleep apnea. |
