Surgery may be an option for select patients with obstructive sleep apnea who are unable to tolerate CPAP. Obstructive sleep apnea surgery will be discussed with you at the Alternatives to CPAP Clinic. Some surgeries are designed to improve CPAP compliance, whereas others are designed to improve, and in some cases, cure sleep apnea.
If CPAP is not an option for you, we may suggest surgery to reduce the soft tissue in your throat, shrink the size of your tongue or to improve airflow through your nose. Surgery for obstructive sleep apnea at the University of Michigan includes the following options:
- Nasal surgery: Nasal obstruction is a common finding in patients with obstructive sleep apnea. Surgical procedures like nasal septoplasty, turbinate reduction and adenoidectomy can lead to an improvement in both day-time and night-time nasal breathing. Nasal surgery is frequently performed to help improve CPAP compliance by allowing a reduction in CPAP pressure requirements and can lead to additional, more comfortable, CPAP mask options including the nasal pillows and nasal masks. Nasal surgery alone is rarely curative of sleep apnea.
- Soft tissue surgery or bony surgery: Often, these procedures are performed in conjunction to address the key sites of upper airway obstruction like the soft palate and base of tongue. Surgery options range from adenotonsillectomy alone (usually for children) or tonsillectomy in adults with additional tongue base surgery to traditional palatal surgery, called uvulopalatopharyngoplasty. Treatment options for base of tongue obstruction include mandibulotomy with genioglossus (tongue) muscle advancement, hyoid suspension, radiofrequency ablation and transoral robotic surgery (TORS). The goal of these surgeries is improvement in the severity of sleep apnea.
- Maxillo-mandibularadvancement: a highly effective option in addressing both soft-palatal and base-of-tongue obstruction. This procedure is curative in a higher proportion of patients with sleep apnea than the aforementioned soft tissue surgeries.
- Tracheotomy– usually considered to be curative and may be performed for treatment of severe sleep apnea.
To schedule an appointment at the multi-disciplinary Alternatives to CPAP Clinic, please call 734-936-9158. A physician referral is required prior to your appointment date.