Multilevel pharyngeal surgery for obstructive sleep apnea: Indications and techniques

Abstract

Patients with moderate to severe obstructive sleep apnea generally manifest upper airway obstruction and collapse at multiple levels. After these collapsing segments are identified preoperatively, the surgical approach should be customized to address the obstruction in a site-specific way. The combination of palatopharyngoplasty with both a hyoid myotomy and a mandibular osteotomy with tongue advancement provides a high rate of surgical success and is described in detail, along with a logical algorithm for patient selection.