Sleep apnea is a potentially deadly condition and it is important that you get treatment that will actually correct it. If other treatment options are not working, sleep apnea surgery should be considered, but only as a last resort. Sleep apnea surgery can effectively reduce the severity of your sleep apnea, but not all surgeries are equally effective, and all carry risk. If you are being encouraged to get sleep apnea surgery, we recommend you get a second opinion before going forward.
This page contains some background information on sleep apnea surgery options, but we recommend you talk to a sleep dentist about your surgical options. Please call 720-317-2700 or email Dr. Paul A. Hamersky today to schedule an appointment at one of his Denver-area offices.
Maxillo-Mandibular Advancement (MMA) Surgery
MMA is a bone reshaping surgery in which both your upper and lower jaw are cut and then advanced forward. Although the surgery is very invasive, and recovery takes many months, it has the highest success rate of any sleep apnea surgery, with an average reduction in your sleep apnea severity of 87%. MMA surgery will likely change your facial appearance, though most people believe it is for the better.
UPPP is a soft tissue surgery that removes the tonsils, soft palate, and uvula to expand the airway. Recovery takes several weeks. Overall, UPPP has a fairly high success rate, with an average sleep apnea reduction of 67%, though several studies show little or no improvement.
For some people, slightly modified versions of UPPP are available to target specific anatomical differences, such as excessive neck fat deposits, small tonsils, and different soft palate configurations. These techniques have not been studied in detail, but they do show some promise.
Laser Assisted Uvulopalatoplasty (LAUP)
LAUP is a relatively noninvasive outpatient surgical procedure. LAUP uses a laser to shorten the uvula and tighten the tissue of the soft palate. This is sometimes used for snoring reduction, but may not achieve a sufficient amount of sleep apnea reduction. LAUP uses a series of treatments, perhaps as much as five during the initial course, with additional retreatments as necessary. This surgery initially had very high promise, but overall studies show modest improvements in sleep apnea, of about 32%.
Upper Airway Radiofrequency (RF) Treatment
This technique uses RF to heat and reshape the tissue of your upper airway. It can be used on the palate, the tongue, and both. Studies on these techniques are relatively sparse. However, evidence indicates that there may be a reduction in apnea by about 34%.
Soft Palate Implants
In this procedure, semi-rigid Dacron rods are inserted in the soft palate to give it more support during sleep. The procedure is less invasive than some other surgeries and requires only local anesthesia. It may result in an apnea reduction of about 26% for appropriate candidates.
Often, multiple surgeries may be recommended. Surgeries can be combined in a single procedure, or you can get one surgery first followed by a second surgery if it is considered necessary. In general, the phased surgical approach tends to produce more favorable results.
Is Surgery Right for You?
Before having sleep apnea surgery, you should talk to a full range of sleep doctors about different treatment options. There may be a good treatment option for you other than surgery, which you can try before committing to the expense, risk, and irreversible nature of surgery.
Dr. Paul A. Hamersky is an orthodontist with more than 30 years’ experience who can give you his perspective on surgery to reshape your jaw or soft palate. To talk to Dr. Hamersky, please contact us and schedule an appointment at one of the Denver-area offices, including Lone Tree, Castle Rock, Stapleton, and Aurora. Call 720-317-2700.