Surgical Treatments of Obstructive Sleep Apnea in Chicago

Many of the surgical procedures performed to remedy chronic, excessive snoring are also surgical procedures used in Chicago to correct Obstructive Sleep Apnea, especially in light of the fact that there is a positive correlation between the two sleep disordered breathing conditions.

Uvulopalatopharyngoplasty (UPPP)

If the airway collapses at the soft palate, a UPPP may be helpful. UPPP is usually performed on patients who are unable to tolerate the C-PAP. The UPPP procedure shortens and stiffens the soft palate by partially removing the uvula and reducing the edge of the soft palate. Usually the surgeon takes out your tonsils, and parts of your uvula and soft palate. This allows more room for airflow and leaves less vibratory tissue in your throat.

Short-term, the procedure stops most people from snoring, but within a couple of years, research shows, only about half the patients undergoing this surgery say that the snoring has stopped or is markedly improved.

Laser-assisted uvulopalatoplasty (LAUP)

A less expensive alternative to UPPP is laser-assisted uvulopalatoplasty (LAUP), which uses laser techniques to shorten the uvula and vaporize parts of your palate. Whereas UPPP is performed under a general anesthetic, LAUP can be done under conscious sedation. LAUP is indicated if you’ve already had your tonsils removed.

Some studies found that snoring did return within 18-24 months in many patients, although it was less disturbing than before. But only 55% of patients reported that their bed partner was satisfied with the outcome. In 2001, an Israeli clinic reported that after a year their patients showed a significant decline in snoring improvement from 88% to 65%; snoring actually worsened in 12% of the cases, possibly because the laser-induced scarring made the back of the throat less flexible.

Cautery-assisted uvulopalatoplasty (CAUP)

Instead of a laser, some physicans use cautery equipment. A heated wire or electrode is used to burn away all or part of the uvula. A 2006 review found the effectiveness of UPPP, LAUP and CAUP procedures to be similar (more than 83%). Postoperative pain was mostly seen in LAUP and UPPP cases. The CAUP procedure was easy and the least painful.

Cautery-assisted palatal stiffening operation (CAPSO)

A procedure in which the surgeon uses electrocautery equipment to remove part of the soft palate — is a cost-effective procedure conducted on an outpatient basis. Some studies of patients showed a 92% short-term success rate, and 77% percent success at 12 months.

Hyoid Suspension

If collapse occurs at the tongue base, a hyoid suspension may be indicated. The hyoid bone is a U-shaped bone in the neck located above the level of the thyroid cartilage (Adam’s apple) that has attachments to the muscles of the tongue as well as other muscles and soft tissues around the throat. The procedure secures the hyoid bone to the thyroid cartilage and helps to stabilize this region of the airway.

Genioglossus Advancement (GGA)

GGA was developed specifically to treat obstructive sleep apnea, and is designed to open the upper breathing passage. The procedure tightens the front tongue tendon; thereby, reducing the degree of tongue displacement into the throat. This operation is often performed in tandem with at least one other procedure such as the UPPP or hyoid suspension.

Maxillomandibular Advancement (MMA)

MMA is a procedure that surgically moves the upper and lower jaws forward. As the bones are surgically advanced, the soft tissues of the tongue and palate are also moved forward, again opening the upper airway. For some individuals, the MMA is the only technique that can create the necessary air passageway to resolve their OSA condition.

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