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Surgical Options

In patients with sleep apnea, the most common initial therapies utilized are weight loss and nasal CPAP therapy. In carefully selected patients, surgical treatment options are appropriate, particularly in children who have large tonsils or in patients who have nasal obstruction or obstruction of the oral airway (often caused by a markedly enlarged uvula).

A variety of surgical treatment options are available to patients with either obstructive sleep apnea or patients who have snoring without obstructive sleep apnea. In general, surgical therapies are more successful in patients who have snoring without sleep apnea. These surgical treatments are performed by an ear, nose, and throat (ENT) specialist. This physician recommends whether such therapies would be appropriate and discusses specific risks and benefits with each candidate.

Since Tracheostomy (a surgical opening to the trachea created in the front of the neck) is now used much less frequently as treatment for severe sleep apnea, one of the most aggressive surgical treatments for sleep apnea therapy is now the uvulopalatopharyngoplasty. This surgery involves the removal of the tonsils, the uvula, and part of the soft palate.

Laser Assisted Uvuloplasty is a less invasive and more cost-effective resection that is performed in the office, usually on three or four sessions involving laser ablation of the tonsils, the uvula, and part of the soft palate. Generally, this procedure is reserved for patients with snoring in whom apnea has been excluded.

Somnoplasty is a rather new procedure, where radio frequency waves are directed in the deep nasal passages or at the base of the tongue. These radio waves can cause shrinking of tissue in carefully selected areas.

A variety of nasal procedures, including Septoplasty (the repair of a deviated nasal septum), can improve nasal airflow. This may help reduce snoring, improve sleep apnea, or allow a patient better tolerate other therapies such as nasal CPAP.

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