Most people who go under the surgical knife for any reason do so because they believe it will be a permanent fix to their problem. If you have a tumor, you have surgery to remove the tumor, right? But what if you knew that there was a high likelihood that that tumor would just grow back? Would you still have the surgery?
Many sleep apnea sufferers have invasive surgery performed at the recommendation of a well-meaning physician. The procedures are generally very painful and have a fairly long recovery period because the surgery is literally cutting tissues out of the patient’s throat. Imagine the worst sore throat that you’ve ever had and then plan on the recovery after surgeries like the UPPP (uvulopalatopharyngoplasty) being a lot worse. Now imagine that you’ve spent all that money, went through all that pain, only to find out later that your sleep apnea wasn’t corrected or that it came back after a while. This is the unfortunate reality for thousands of people every year. In fact, according to a study published in the journal SLEEP that systematically reviewed surgical modifications to the upper airway, surgeries like UPPP that modify the soft palate “inconsistently reduced” AHI (a measure of how bad sleep apnea is). The study should only 33% of patients saw an improvement in their sleep apnea, with patients still showing elevated AHI of 29.8 on average, which puts them at the high end of the moderate sleep apnea category according to the American Academy of Sleep Medicine. Patients with an AHI of more than 30 are considered to have Severe Obstructive Sleep Apnea.
One reason for these poor numbers is scar tissue. Just like any other part of your body, when your throat is cut, during the healing process, scar tissue is produced at the injury site. This scar tissue can just as easily lead to airway blockage as the original tissue in the throat. Of course, the uvula and tonsils do not grow back, but new tissue does form. There are even some reported cases of patients having worse snoring and sleep apnea symptoms than before the surgery.
According to the 2010 SLEEP surgical review study, the most successful surgical procedure for treating sleep apnea was Maxillo-mandibular advancement (MMA). Here is the description of the procedure according to the study:
Maxillo-mandibular advancement (MMA) is a multilevel skeletal surgery designed to enlarge the velo-orohypopharyngeal airway without direct manipulation of the pharyngeal tissues. It advances the anterior pharyngeal tissues (soft palate, tongue base, and suprahyoid musculature) attached to the maxilla, mandible, and hyoid bone and is accomplished by LeFort I and bilateral sagittal split rami osteotomies that are stabilized with screws, plates, or bone grafts.
In essence, this procedure opens the airway by extending the bones of the upper and lower jaw. The medical term they use above is osteotomies (osteo = bone, tomies = cuts). Wouldn’t it be great if there was a non-surgical method to advance the mandible and accomplish the same thing?! WAIT, THERE IS: oral appliance therapy!
With these facts in mind, patients should only approach surgical treatment of sleep apnea as a last resort when all other options have failed. Oral appliance therapy is non-surgical, non-invasive and significantly less expensive surgery. It’s also more comfortable for most patients than CPAP, another non-surgical sleep apnea treatment.