Surgical management should be considered an important component in the management of patients with obstructive sleep apnea (OSA). Surgery has multiple roles including primary therapy for patients having failed medical management (positive airway pressure, mandibular advancement devices) and as an adjunctive therapy to allow for improved compliance with such medical therapies. Please refer to the AAO-HNS Position Statement on Treatment of OSA
for further information.
The following procedures are effective and not considered investigational when considered as part of a comprehensive approach in the medical and surgical management of adults with OSA. Some patients may require one or more of these procedures performed individually or sequentially on the following anatomic areas. These surgical procedures include, but are not solely limited to the following:
- Nose (please refer to AAO-HNS Nasal Surgery and OSA Position Statement)
- Hard palate
- Palatal advancement (Woodson, 20051)
- Soft palate
- Palatine tonsils
- Pharynx and associated musculature
- Expansion sphincter pharyngoplasty (Pang, 20002)
- Base of Tongue
- Lingual tonsils
- Lingual tonsillectomy - electrocautery, coblation and robotic (Lin, 20093; Lee, 20124)
- Tongue and associated musculature
- Supraglottis / Hypopharynx
- Maxillary and Mandibular Advancement (Pirklbauer, 20116)
Woodson BT, Robinson S, Lim HJ. Transpalatal advancement pharyngoplasty outcomes compared with uvulopalatopharygoplasty. Otolaryngol Head Neck Surg. Aug 2005;133(2):211-
Pang KP, Woodson BT. Expansion sphincter pharyngoplasty: a new technique for the treatment of obstructive sleep apnea. Otolaryngol Head Neck Surg. Jul 2007;137(1):110-114.
Lin AC, Koltai PJ. Persistent pediatric obstructive sleep apnea and lingual tonsillectomy.
Otolaryngol Head Neck Surg. Jul 2009;141(1):81-85.
Lee JM, Weinstein GS, O'Malley BW, Jr., Thaler ER. Transoral robot-assisted lingual tonsillectomy and uvulopalatopharyngoplasty for obstructive sleep apnea. Ann Otol Rhinol Laryngol. Oct
Digoy GP, Shukry M, Stoner JA. Sleep apnea in children with laryngomalacia: diagnosis via sedated endoscopy and objective outcomes after supraglottoplasty. Otolaryngol Head Neck Surg. Sep 2012;147(3):544-550.
Pirklbauer K, Russmueller G, Stiebellehner L, et al. Maxillomandibular advancement for treatment of obstructive sleep apnea syndrome: a systematic review. J Oral Maxillofac Surg. Jun