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Surgery can be broadly divided into the following groups:
The type of surgery discussed from this point are those performed by Ear Nose Throat (ENT) Specialists. The weight loss surgery is usually performed by general surgeons. Information on surgery for OSA in children is available elsewhere. Surgery on the soft tissue of the nose and throat.ENT Surgeons assess the nasal passages, throat, voice box and windpipe as part of their routine clinical examination. This examination usually involves the use of a special nasal telescope. In patients with OSA or snoring, there are often point of blockage which can be surgically corrected. Depending upon other factors, such as the patient's weight, the success of these procedures in curing OSA is variable. Often OSA is caused by blockage at several levels of the airway. Due to the discomfort associated with surgery in the nose and throat, it is often safer and more comfortable to have the procedures spaced out over several different anaesthetics. ENT Specialists call this "staged" surgery and it is becoming increasingly common. Nasal surgery usually involves correcting deviations of the midline partition of the nose called the "septum" as well as shrinking down the soft tissue on the side walls of the nasal cavity. If you have sinus problems as well, then sinus surgery may also be performed at the same time. In some instances the nose is so crooked that it can only be straightened with an operation called a "rhinoplasty". In some rare cases, the side walls of the nose have become weakened and the nostrils collapse when the patients breathes in through their nose. This can be strengthened to reduce the chance of collapse. Throat surgery may be necessary if the patient has, for example, big tonsils, a long soft palate and uvula (the thing that dangles down at the back of our throat), a big tongue, if the side walls of the throat collapse inwards, or the protective valve over the voice box (called the epiglottis) is unstable and blocks off the windpipe. With so many possible sites of blockage, it is now obvious to ENT Specialists with specific training in Sleep Apnoea surgery as to why operating on the soft palate alone (an operation called a uvulo-palato-pharyngo-plasty or UPPP or U-tripple-P) did not help many people (in fact maybe only about one third had an improvement). This highlights the importance of an appropriate assessment. Surgery for the bones of the face.Sometimes people are born with a short jaw bone or the middle part of their face does not grow forwards enough. Both of these problems result in a narrowing of the airway. In such cases, it may be necessary to lengthen the bones and bring them forwards. An alternative is to bring forwards the front middle part of the chin. The decision on the necessity of these procedures is made by an ENT Specialist and other surgeons of the bones of the face. More informationWe suggest talking to your GP or sleep disorder specialist about your problems. We are more than happy to organise an appointment with an ENT Specialist. |
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