Obstructive Sleep Apnea (OSA) is a common sleep disorder, which can affect any person, irrespective of age. The condition occurs when the muscles of the body relax during sleep, causing blockage of the upper airway completely or partially due to collapse of the soft tissue at the back of the throat. This disturbs sleep, with the person waking up many times during the night gasping for air to resume normal breathing. Based on severity of the symptoms, there are various options to treat this breathing disorder.
Treatments for Obstructive Sleep Apnea
The most common form of treatment for patients suffering from OSA is the usage of a nasal CPAP (continuous positive airway pressure) machine which delivers air through a nasal or face-mask under pressure. When the person sleeps, this machine gently increases air pressure in the throat holding it open, thus preventing snoring and OSA. However, if the problem persists even with the use of this device, then the physician usually recommends surgical treatment. Surgical correction is required in the following situations:
- Anatomic airway defects
- Co-existing conditions such as heart arrhythmias, high blood pressure and more
- Extreme as well as medium OSA
- Patients with low apnea who still experience extreme sleepiness during daytime
The surgical options for sleep apnea are as follows:
- Tracheostomy – The procedure involves inserting a tube in the windpipe through a permanent hole, bypassing the site of upper airway obstruction. The patient breathes and speaks in a normal way as the tube is capped during the day time. This option is recommended only when other treatments have failed or when treatment is needed right away. Likely complications associated with this procedure include bleeding, recurring bronchitis and stenosis.
- Tonsillectomy – This procedure, a first-line treatment for children suffering from OSA, involves the removal of the adenoids and tonsils, which reduces sleep-related breathing disorders.
- Uvulopalatopharyngoplasty (UPPP) – The procedure involves the removal of the tonsils and tightening of the pharynx walls, and helps in eliminating the obstruction in the upper airway. One of the most common surgical treatments for mild to moderate OSA, UPPP is recommended for patients with extra soft tissue of the palate and uvula.
- Genioglossus Advancement – This procedure is usually combined with other surgical procedures to correct a small airway. The muscles of the tongue base are advanced forward on a small piece of bone that is attached to the mandible. The hypopharyngeal airway is enlarged, which ensures smooth breathing.
- Hyoid Myotomy – This procedure involves enlarging the airway by advancing the muscles of the tongue base forward. This causes the tongue base to pull away from the back of the throat and prevents collapse or falling backward during sleep. It is usually not performed as a standalone procedure and combined with other procedures that enlarge this portion of the airway.
- Maxillomandibular Advancement (MMA) – This involves cutting the bones of the lower as well as the upper jaw and advancing them forward. This highly effective procedure improves sleep apnea and is also useful for treating several other medical problems related to the disorder.
- Distraction Osteogenesis – The procedure is helpful in treating airway obstruction in toddlers and neonates. It involves making surgical incisions in the lower jawbone and placing devices over these incisions to gradually stretch the bones. The treatment helps restore a more anatomically normal bony shape. Moreover, children undergoing this surgery can avoid the need for future tracheostomy and associated long-term complications.
Effective results and safety are ensured when sleep apnea treatment is provided by an experienced and reliable plastic surgeon at an AAAASF-accredited plastic surgery facility. Expert surgeons extensively trained in plastic and craniofacial surgery can provide optimal results for moderate to severe conditions.