Snoring

Overview

In Chapel Hill, Raleigh and Durham sleep apnea and snoring can be remedied by a number of different surgeries available to improve the size or tone of a patient's airway. Modern operations employ one or more of several options, tailored to each patient's needs.

Surgery is a possibility for some patients; however, it is important to keep in mind that no surgical procedure is a guaranteed success. Each patient has a uniquely shaped nose and throat, so before the surgical option is considered, your surgeon will do some tests to determine if there is any abnormal airflow between the nose and the lungs. He has been specifically trained to perform the following procedures:

Removal or reduction of parts of the soft palate and some or all of the uvula. More modern variants of this procedure use radiofrequency waves to heat and remove tissue.
Reduction of the tongue base, either with laser excision or radiofrequency ablation.
Genioglossus Advancement. In this procedure a small portion of the lower jaw that attaches to the tongue is moved forward, tightening the tongue tendon, to pull the tongue away from the back of the throat and keep it from blocking the upper breathing passage. Many times this procedure is performed in conjunction with another procedure, such as hyoid suspension or UPPP.
Hyoid Suspension. Another option is hyoid suspension in which the hyoid bone in the neck, another attachment point for tongue muscles, is pulled forward in front of the larynx, thus augmenting the airway. The hyoid bone is attached to the thyroid cartilage and establishes a more secure and stable airway.
Maxillomandibular advancement (MMA). A more invasive surgery usually only tried in difficult cases where other surgeries have not relieved the patient's OSA, or where an abnormal facial structure has been determined to be the cause. In MMA, the patient's upper and lower jaws are moved forward, thus moving the tissues of the tongue and palate with it, allowing for greater airflow. For some, this may be the only viable option for relieving OSA.

Possible Complications

Surgery on the mouth and throat, as well as dental surgery and procedures, can result in postoperative swelling of the lining of the mouth and other areas that affect the airway. Even when the surgical procedure is designed to improve the airway, such as tonsillectomy and adenoidectomy or tongue reduction - swelling may negate some of the effects in the immediate postoperative period.

The surgeon may monitor sleep apnea patients for several hours after the last dose of anesthesia and other sedatives, longer than non-sleep apnea patients require and possibly through one full natural sleep period. Same-day surgery may not be appropriate for some sleep apnea surgery patients.

The period of awakening from anesthesia after surgery can also be problematic for sleep apnea patients. In patients who have undergone surgery to treat sleep apnea, the airway can be narrowed from swelling and inflammation. There may also be some upper airway swelling.

Recovery

Normal activity level, such as your job, unless it requires higher levels of physical strain such as construction, is typically resumed after approximately one week of convalescence. Some swelling is to be expected for up to three weeks after the procedure, along with slight to moderate discomfort, easily managed by over the counter analgesics. If your pain reaches levels uncontrollable by these, your surgeon will prescribe a more appropriate drug to manage your pain. You can resume normal food consumption as soon as 3 days after the surgery, beginning with softer foods, and gently easing into more solid ones. Speech may be slightly affected, but not hindered.

All this depends on the specific procedure performed on you. Rest assured, your surgeon will explain to you beforehand what to expect during convalescence.

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