Common Illness

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Video on Oral Appliance For Sleep Apnea

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Oral Appliance For Sleep Apnea
Alex Rider
Ideally people undergoing surgery to reduce sleep apnea should be below 60 years of age, not overweight, have a moderate to mild OSA severity (i.e. a respiratory disturbance index (RDI) of less than 30) and have an oropharyngeal (easier to operate regions of the palate, tonsils or uvula) instead of hypopharyngeal obstruction (more difficult to treat region of the head centered around the tongue base and hypopharyngeal structures).
Two (from a range of surgical treatment options) significant surgical sleep apnea operations are now detailed.
Nasal surgery
OSA sufferers commonly complain of obstructions within their own nose airways. Blockages may be from a collapsed or very narrow nasal valve. Surgery on the nose has been found to be very successful at furthering breathing, decreasing the turbinate size, enlarging the nasal valve or correcting deviations in the septum.
Mid to high severity OSA sufferers have been found to require more than nose surgery to alleviate their breathing problems. Nasal surgery can often be done to aid someone's used of continuous positive airway pressure (CPAP) therapy.
Taking around one hour to complete, nasal surgery is conducted under general anaesthesia. When the patient awakens only a slight discomfort tends to be felt, easily controlled with a few medications over a couple of days. Sometimes modified areas require structural support in the form of small pieces of sponge that are placed deep inside temporarily. Although potentially slightly uncomfortable and requiring removal at a later date, this method is not always required or used.
Rare infections or heavy bleeding have been the commonest of possible associated complications.
Radiofrequency surgery
Radiowaves are used to decrease the volume of soft tissues in the nasal turbinates, tongue or soft palate. This surgical technique is accurate and uses temperatures of 60-90 degrees celcius, limited to the are being operated on.
Local anaesthetics are injected into the areas to be modified, treatment probes that release the high energy radiowaves then getting inserted where the tissue requires reduction. Only small levels of discomfort are generally experienced during and after this procedure.
Healing tends to take 1-3 weeks. Scar tissue that then ensues actually shrinks the tissue which helps enlarge the airways.
Nasal turbinates are operated on in around 15 minutes. After the operation people are generally able to immediately resume their normal activities without any hindrance's. A low level of nasal stiffening is all that may be felt for 3-5 days after the surgery.
Reducing the volume of the tongue tends to take around 20 minutes, again involving low levels of discomfort. Complications that have been known to occur are infections and strong swellings. Since these complications are increased with time spent receiving radiotherapy multiple sessions of treatments are generally conducted.
Soft palate reduction is largely only beneficial to people suffering from low to mid levels of sleep apnea. Radiowaves stiffen the problem tissue therefore enlarging the airways. Local anaesthesia via injection is used, the operation takes on average 10 minutes to complete with minimal discomfort. After the operation the patient tends to be able to engage in all their usual activities. For around 2-3 days swallowing and sleeping may be slightly more difficult than usual since the swelling of the soft palate will at first be a noticeable obstruction.
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