Sleep Apnea Surgical Treatments
What is Inspire® therapy (Upper Airway Stimulation)?
Inspire® therapy (Upper Airway Stimulation) is an FDA-approved, minimally invasive, implantable device that delivers mild stimulation to the nerves of the tongue muscles, thereby keeping the airway open during sleep.
In clinical trials, Inspire therapy:
- reduced partner reported snoring by 76%
- significantly reduced sleep apnea (pauses in breathing) events by 78%
Is Inspire therapy right for you?
To determine if Inspire therapy is right for you, patients need to be evaluated by a physician. In general, someone may be a candidate if you:
- have completed a sleep study
- have moderate to severe Obstructive Sleep Apnea
- are unable to use or get consistent benefit from CPAP
- are over the age of 22
- are not significantly overweight (BMI < 32)
To learn more about this innovative treatment, please call 617.414.5105
Radiofrequency Turbinate Reduction (RFTR)
Increased nasal congestion has been shown to cause or contribute to snoring, disrupted sleep, and even sleep apnea. Patients with structural problems of the nose (i.e. deviated septum) often benefit from this surgery. RFTR uses radiofrequency to shrink swollen tissues in each side of the nose. This procedure can be performed in the office under local anesthesia.
Upper Throat Surgery
In many patients with OSA, airway narrowing and collapse occurs in the area of the soft palate, tonsils, and uvula. The specific type and combination of procedures that are indicated depend on each individual’s unique anatomy and pattern of collapse. Therefore, the procedure selection and surgical plan is customized to each patient. These procedures aim to enlarge and stabilize the airway in the upper portion of the throat.
The surgery is performed in an operating room under general anesthesia, either as an outpatient or with an overnight hospital stay. The recovery varies depending on the patient and the specific procedures performed. Many patients return to school/work in approximately one week and return to normal diet and activity at two weeks. Throat discomfort, particularly with swallowing, is common in the first two weeks and usually managed with medications for pain and inflammation. Risks include bleeding, swallowing problems, and anesthesia complications, although serious complications are uncommon.
The tonsils and adenoids may be the sole cause of snoring and sleep apnea in some patients, particularly children. In children, and in select adults, with OSA and enlarged tonsils/adenoids, tonsillectomy/adenoidectomy alone can provide excellent resolution of snoring, sleep apnea, and associated symptoms.
Lower Throat Surgery
The lower part of the throat is also common area of airway collapse in patients with OSA. The tongue base may be larger than normal, especially in obese patients, contributing to blockage in this area. The tongue may also collapse backward during sleep as the muscles of the throat relax, particularly when some patients sleep on their back. The epiglottis, or upper part of the voice box, may also collapse and contribute to airway obstruction.
Multiple procedures are available to reduce the size of the tongue base or advance it forward out of the airway. Other procedures aim to advance and stabilize the hyoid bone which is connected to the tongue base and epiglottis. As with palatal surgery, the most appropriate type of procedure varies from one individual to another depending on the pattern of obstruction.
Lower throat procedures are done under general anesthesia, often with an overnight hospital stay. Recovery and risks vary depending on the procedure, but are generally similar to procedures in the upper throat.
What should I know before considering surgery?
Surgery is an effective and safe treatment option for many patients with snoring and sleep apnea, particularly those who are unable to use or tolerate CPAP. Proper patient and procedure selection is critical to successful surgical management of obstructive sleep apnea. Talk to your Ear, Nose and Throat doctor for a complete evaluation and to learn what treatment may be best for you.