Is Surgery Effective?

Does It Work?

Sleep Apnea

Historically, surgery for sleep apnea has yielded mixed results. In the 1980’s and 1990’s, surgery mainly consisted of the uvulopalatopharyngoplasty (UPPP). This procedure aimed to reduce airway obstruction in the region of the soft palate. Obstructive sleep apnea is far more complex in that it is a disease of multilevel airway obstruction, affecting not only the palate, but also the tongue and larynx. Therefore, a single surgical procedure aimed at only one level of obstruction will not yield good results.

The modern approach to surgical management of obstructive sleep apnea involves multi-level airway surgery. This involves multiple procedures performed at the same time, yielding increased success (Ref. 1).

What defines surgical success?

Surgical success is defined as a reduction in the apnea-hypopnea index (AHI) by 50% and an apnea-hypopnea index less than 20. It is important to understand that surgical success does not imply cure of obstructive sleep apnea, as many factors contribute to obstructive sleep apnea. However, surgery has been shown to consistently reduce the severity of a patient's obstructive sleep apnea.  This has advantages in improving CPAP utilization and reducing the health risks associated with obstructive sleep apnea (Ref 2).

Is surgery safe?

Since opening the Ochsner Snoring Center, we have performed hundreds of surgical procedures for obstructive sleep apnea and snoring and with no major complications. Most patients will go home immediately after surgery, however, in certain cases we do observe patients for one night, especially those with severe obstructive sleep apnea.      

Questions?

Our director of the Snoring Center and our specialists are here to personally answer your questions and comments. Email aanand@ochsner.org to submit any questions or feedback.

References

  1.  Lin HC et al.  The efficacy of multilevel surgery of the upper airway in adults with obstructive sleep apnea/hypopnea syndrome.  Laryngoscope.  2008.  118:902-908.
  2. Friedman M et al.  The effect f multilevel airway surgery on continuous positive airway pressure therapy in obstructive sleep apnea/hypopnea syndrome.  Laryngoscope.  2009.   119(1):193-196.