Options Available for Treating Obstructive Sleep Apnea

Obstructive Sleep Apnea (OSA) is a sleep disorder which can be affect any person, irrespective of age. It is characterized by repeated pauses in air flow during sleep. This condition occurs when the soft tissue at the end of the throat collapses, blocking the upper airway partially or completely at different times. This makes the person wake up slightly many times during the night gasping for air to resume normal breathing. It is crucial to seek medical attention as OSA can cause health problems such as a heart attack, a stroke, depression, diabetes or high blood pressure.

Surgical and Non-surgical Treatment Options for OSA

Based on the severity of symptoms, there are various options for treating OSA.

The most common form of non-surgical treatment for OSA is the use of a nasal CPAP (continuous positive airway pressure) machine connected to the nose or face mask via tubing. This machine prevents sleep apnea by blowing air into the mask which keeps the airways open and holds the tissues in place.

However, if the problem persists even with the use of the CPAP machine, surgical treatment would become necessary. Surgery can resolve moderate or severe complications such as daytime sleepiness, airway blockage and high blood pressure.

Surgical Options

• Tracheostomy - In tracheostomy, the surgeon makes an incision on the lower neck and places a tube through this opening into the trachea to provide an airway. The patient can breathe and speak in a normal way as the tube is capped during the day time. Tracheal stenosis, bleeding and recurrent bronchitis are the long-term issues associated with this treatment.
• Tonsillectomy - This is a first line treatment for children suffering from breathing irregularities, which involves the removal of the adenoids and tonsils, resulting in reduction of sleep-related breathing disorders.
• Uvulopalatopharyngoplasty (UPPP) - This is one of the most common surgeries, recommended for patients with extra soft tissue of the palate and uvula. In this treatment, the obstruction in the upper airway is eliminated by removing the tonsils and tightening the pharynx walls to rectify airway abnormalities. This reduces the severity of the condition and reduces snoring by widening the airway.
• Genioglossus Advancement - This procedure is usually combined with other surgical procedures to correct the small airway. The muscles of the tongue base are advanced forward on a small piece of bone that is attached to the mandible. As a result, the hypopharyngeal airway is enlarged which ensures smooth breathing.
• Hyoid Myotomy - This procedure involves enlarging the airway by advancing the muscles of the tongue base forward resulting in pulling away the tongue base from the back of the throat. It is usually not performed as a standalone procedure, but combined with other procedures that enlarge this portion of the airway.
• Maxillomandibular Advancement (MMA) – This treatment involves cutting the bones of the lower as well as the upper jaw and advancing them forward. This is a highly effective procedure that helps in improving sleep apnea and is also useful for treating several other medical problems that related to sleep apnea.
• Distraction Osteogenesis - The procedure is helpful in treating airway obstruction in toddlers and newborns. It involves making surgical incisions in the lower jawbone and gradually stretching the bones by placing devices over the incisions. The procedure helps to restore a more anatomically normal bony shape. Children undergoing this surgery can avoid a future tracheostomy and associated long-term complications.

For safe procedures and an optimal outcome, it is crucial that sleep apnea treatment is provided by an experienced plastic surgeon at AAAASF-accredited plastic surgery center.

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