The goal in this procedure is to make more room in your airway by removing tissue from several structures at the back of your throat. This includes the uvula, the dangling tissue at the back of your mouth, and the soft palate, the rear section of the roof of your mouth, which can obstruct your airway.
It seems like a promising approach, and that’s part of the reason why it’s the most commonly performed sleep apnea surgery. However, its success rate is low, about 50% of less in studies. Many surgeons offer slight variations on the process, and there are laser and radiofrequency alternatives, but there is not enough evidence to support that these alternatives are any more effective.
This procedure also seeks to make your airways more spacious. But instead of trying to reduce crowding by removing “clutter,” in this procedure, the goal is to make your mouth bigger. Both your upper and lower jaws are broken apart, then secured with titanium plates and allowed to heal.
The benefit is that this surgery is almost 100% effective. The tradeoff is that this procedure is very invasive and requires a long recovery period. There are also some serious side effects. About 12-14% of patients experience permanent nerve damage, and up to 44% of patients may develop bite or jaw function problems. Broken plates can also occur, which can impact your healing, require supplemental procedures, and cause additional pain.
The nose is often a culprit in snoring, but less so in sleep apnea. Still, obstructions in the nasal airway can contribute to sleep apnea, so nasal surgeries are sometimes recommended. The most common targets of nasal surgery are the septum and the turbinates. The septum is the dividing structure in your nose, and if it’s off, it can lead to a narrow airway that is subject to blocking. The turbinates are filtering structures in your nose, but they can sometimes contribute to excess clogging of the nose.
Tracheostomy is a 100% effective treatment option for sleep apnea, but it requires the creation of a hole in the throat that can serve as an alternate breathing tube. The quality of life side effects and high risk of surgical complications generally make this an unattractive treatment option.
The tongue is one of the most important structures for interfering with the airway. There are several approaches to reduce blockage by the tongue. Cutting away parts of the tongue, known variously as glossectomy or glossial advancement, is the simplest. A new approach that shows promise is hypoglossial stimulation when your body is implanted with what might be described as a “pacemaker” for your tongue, which stimulates it so it doesn’t relax and crowd the airway.
Hyoid advancement is surgery to relocate the hyoid bone to increase the size of the airway.
If you are considering sleep apnea surgery and would like to learn more about your other options, please call (303) 691-0267 for an appointment with a Denver sleep dentist at the TMJ Therapy & Sleep Center of Colorado.