Surgical treatment of obstructive sleep apnea: standard and emerging techniques

Abstract

Patients who are nonadherent to CPAP must be thoroughly evaluated before choosing any of the available surgical options. Upper airway surgery may improve disease markers of OSA, if appropriately chosen and properly indicated and performed.

Inflammation in sleep apnea: An update

“…Mandibular advancement devices, designed to lift soft tissues from the site of airway collapse, can be effective in some cases of OSA[11]. Surgery may be used to address anatomical problems (e.g., enlarged tonsils), or used as a salvage treatment for patients who are not able to use CPAP[12]. Newer treatment modalities for OSA, such as upper airway nerve stimulation are in development[13].…”

Redefining the timing of surgery for obstructive sleep apnea in anatomically favorable patients

“…Considerable research has been published assessing the effectiveness of surgery in the treatment of OSA. Although from an anatomical perspective, many patients with OSA are not suitable for pharyngeal expansion procedures; in appropriately screened patients, data demonstrate that surgery can produce substantial and sustained long‐term improvements in both sleep study indices and patient‐specific outcomes . Several technically distinct surgical procedures have been attempted for OSA, so relatively few randomized studies exist evaluating any single procedure.…”

Outcomes of uvulopalatopharyngoplasty with harmonic scalpel after failure of continuous positive airway pressure in sleep apnea syndrome

“…For these reasons, continuous positive airway pressure (CPAP) therapy is the treatment of choice for OSA. Although CPAP is effective in the treatment of OSA, a significant portion of the population with OSA has difficulty with compliance [3,4]. Previous studies report that only 46% of patients are consistent users of CPAP, and in addition, there is increasing recognition in the literature of refractory sleepiness in patients successfully treated with CPAP [3,4].…”