SURGICAL OPTIONS FOR SLEEP APNEA
The first alternative sleep apnea treatment I will address is surgery. Currently there are a variety of different surgery options available to treat sleep apnea. These options include procedures performed on the palate, tongue and jaw. Genioglossus advancement, maxillomandibular advancement, maxillomandibular expansion, pharyngoplasty, uvulopalatal flap are examples. Pictures of each of these procedures can be viewed at www.sleepapneasurgery.com. We recommend looking at the pictures and doing some research on the effectiveness and potential side-effects before you decide to go ahead with one of these surgeries.
The pharyngoplasty and uvulopalatal flap are concerned with the soft tissues of the throat/airway only. Pharyngoplasty usually includes tonsillectomy and airway expansion by use of sutures. A tonsillectomy is also performed with the uvulopalatal flap. The uvulopalatal flap is a soft palate lift which expands the airway. While these procedures are less invasive than those that involve the jaw, recovery can be painful and the result is often ineffective in eliminating sleep apnea.
Genioglossus advancement involves pulling the tongue forward via a cut-out of the bone of the lower jaw and keeping it in that position permanently. Pulling the tongue forward should prevent it from falling into and blocking the airway while the person is asleep. Speech and swallowing are not affected. However, side effects do include pain and swelling, and intermittent numbness of the front teeth of the lower jaw. This procedure may also change the shape of the jaw to some degree.
Maxillomandibular advancement involves cutting both the upper and lower jaws and moving the bones forward to enlarge the airway. Plates, screws, braces and rubber bands are used to keep the jaws in their new positions and keep the teeth properly aligned. The patient is not able to chew for 4 weeks after the surgery. The facial profile will change with this procedure. Since many people with obstructive sleep apnea have narrow jaws, a procedure called maxillomandibular expansion was developed. This surgery involves cutting the jaw bone and orthodontic treatment is required to reposition the teeth. There will be a change in the facial profile, although speech and swallowing are not affected.
While all of the surgeries mentioned above have their place in the treatment of sleep apnea when the airway is affected by jaw structure and the tongue, there can be undesirable side-effects and sleep apnea is not always eliminated. Doing your own research prior to a physician consultation is recommended. Then ask as many questions as possible and maybe even get a second opinion before consenting to go under the knife.