Surgical Treatment of Obstructive Sleep Apnea

Abstract

SUMMARYIn summary, there are several possible surgeriesthat may be performed on patients with OSA(Table 2 summarizes the maxillomandibularadvancement, tracheostomy and uvulopalato-phayrngoplasty results). However, the most effec-tive surgeries in adults are maxillomandibularadvancement surgeries and tracheostomies, withsuccess rates of 86% and 73%, respectively. Tra-cheostomies have a higher rate of patient dissatis-faction than maxillomandibular advancement.Surgical success in children is currently 83%when adenotonsillectomy is performed. Improvedsurgical success is obtained with careful preoper-ative planning and assessment for areas ofobstruction as demonstrated by surgical successof uvulopalatopharyngoplasty in 52% of patientswith retropalatal obstruction only, compared withsurgical success rate of only 5% in those withany component of retrolingual obstruction. 47 Sleep surgery failures should be evaluated withmodalities that allow for assessment of the spe-cific area of obstruction. A multidisciplinary teamis necessary and should include an experiencedsurgeon as well as a sleep-trained orthodontistto maximize short- and long-term surgicalsuccess.