Sleep Apnea and Surgery – The Lowdown on Sleep Apnea Surgery Options

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Sleep Apnea and Surgery

I’m sure you are well aware that sleep apnea can have extremely serious consequences for your health.

The muscles in your throat tend to relax while you are asleep which causes your breathing to stop periodically. This may lead to loud snoring, choking noises or leave you gasping for air.

The list of conditions that may be caused by sleep apnea is seemingly endless and can include:

  • Stroke
  • Hypertension
  • Coronory artery disease
  • Congestive heart failure
  • Cardiac arrhythmias
  • Heart disease
  • Type 2 diabetes
  • Obesity
  • Gastroesophageal reflux disease
  • Sexual dysfunction
  • Sudden death (Please take a look at my article – Can You Die From Sleep Apnea)

I haven’t even mentioned what effects the loud snoring may have on you and your partner. The lack of sleep you are getting can lead to mood swings and chronic fatigue and tiredness during the day.

There are of course various natural treatments, but today I wish to focus on sleep apnea and surgery.

The numerous forms of surgery to treat sleep apnea are wide and varied and can be extremely confusing. The best option for you will depend on how severe your sleep apnea is and your overall health.

I will list the various types of sleep apnea surgery, give you an idea of the costs involved, and finally look at the expected recovery time after surgery.

Uvulopalatopharyngoplasty

Uvulopalatopharyngoplasty, sometimes referred to as UPPP or UP3, is one of the main types of surgery used to treat obstructive sleep apnea.

It requires the removal of soft tissue at the back of the throat, such as the tonsils and the adenoids. Often other soft tissues, Sleep Apnea and Surgery

including the uvula, soft palate, and the pharynx, may need remodeling or repositioning in order to make the airway wider.

You will expect to pay $2,000-$10,000 for UPPP. The price will very much depend on what your surgeon believes is required after a complete diagnosis. For example, having the uvula trimmed will see costs at the lower end of the scale, whereas if the tonsils and adenoids need to be addressed then the price will soar to the upper end of the scale.

Full recovery from UPPP will usually take anywhere from 3-6 weeks, although you should be able to return to work after a week or two. Over the course of 3-6 weeks you should find that your airflow is much better and you’ll snore less, if at all.

Maxillomandibular Advancement

Maxillomandibular advancement is a form of jaw surgery used to treat obstructive sleep apnea.

The jaw is advanced in order to expand the airway. This involves repositioning the bones of both the upper and lower jaw, which should relieve any obstruction to the airway.

The cost of maxillomandibular advancement can vary widely, from $3,000-$50,000. However, in terms of treatment for sleep apnea this price typically falls between $20,000-$40,000.

If you’re looking at soft palate reduction then the cost will be under $5,000.

However, most cases of maxillomandibular advancement involve several examinations, x-rays, general anesthesia, bone cutting, bone reshaping and repositioning of the jaw.

If you only require surgery on one jaw the price will be approximately $20,000, and this doubles for both the upper and lower jaw.

The recovery time from maxillomandibular advancement surgery will usually take six weeks, although the complete healing process can take up to 12 weeks. However, you can expect to return to work around 3 weeks after surgery.

Radiofrequency Volumetric Tissue Reduction

Radiofrequency volumetric tissue reduction (RFVTR) is a procedure more commonly used to treat snoring, but it is sometimes used to help with sleep apnea.

The procedure makes use of low-power and low-temperature radiofrequency waves to shrink or remove tissues at the back of the throat, such as the soft palate, in order to open up the airway. This is considered to be a minimally invasive procedure.

You will expect radiofrequency volumetric tissue reduction to cost $5,000-$10,000.

The recovery time can range from as little as a week up to 3 weeks.

Palatal Implants or the Pillar Procedure

A palatal implant involves surgically placing three cylinder-shaped polyester rods permanently into the soft palate. This form of surgery for sleep apnea is often referred to as the Pillar procedure. The implants measure 18 millimeters in length and 1.5 millimeters in diameter.

Once the tissue heals around the implants after surgery the soft palate will stiffen, which reduces the vibration and relaxation of the tissue. The procedure is actually intended for snoring, but can be used to treat mild cases of sleep apnea.

The Pillar procedure is completed under local anesthesia and is typically done in your doctor’s office.

The cost of palatal implants will range from $1,800-$2,700.

You will usually be required to sit for a few minutes after the procedure, as your doctor will want to ensure that there isn’t any significant bleeding or swelling.

You may be asked to use an antiseptic rinse and prescribed an antibiotic for a few days in order to prevent infection. You may also be prescribed an anti-inflammatory if you feel any pain after the anesthetic has worn off, or if there is excessive swelling.

However, in most cases you should be able to eat and resume your normal activities on the same day.

Septoplasty and Turbinate Reduction

Turbinate reduction is usually recommended for people who undergo septoplasty.

Septoplasty is a surgical procedure that corrects a deviated septum, which in turn can straighten out the nasal cavities and Sleep Apnea and Surgery

make it easier to breath.

The turbinates are the curved bones which are located along the walls of the nasal passage. A turbinate reduction (reducing the size of these bones through surgery) will typically follow a septoplasty and open up the airways further.

Septoplasty will generally cost from $5,000-$7,000 and with addition of turbinate reduction the overall price will be in the range of $10,000.

The recovery period from septoplasty and turbinate reduction will happen in stages. You may have swelling of the face for up to 3 days and nasal drainage and bleeding for up to 5 days. You may also experience nasal stuffiness and fatigue following surgery. You will expect mild pain and this is treated with mild oral painkillers.

The recovery from the less invasive turbinate reductions will generally be quick and pain-free, say within 3 weeks. However, the more invasive type of surgery you may need between three and six months to fully recover.

Hyoid Suspension

Hyoid suspension is also known as hyoid myotomy and suspension or hyoid advancement.

This procedure involves moving the base of the tongue and the epiglottis (the leaf-shaped flap of elasticated tissue in the throat) forward. It is often performed in conjunction with a uvulopalatopharyngoplasty.

This is achieved by cutting into the upper throat and detaching various tendons and muscles so the hyoid bone can be moved forward. The vocal cords are not impacted during surgery so this won’t cause any changes to your voice.

The cost of hyoid suspension will be from $2,000-$10,000.

You should avoid any heavy lifting or vigorous activity, such as exercise, for at least 2 weeks, but you can expect to return to work within 10-14 days.

You should drink plenty of fluids for the first couple of weeks after surgery, consuming a drink every hour while awake. It is recommended that you follow a “soft diet” for this same period. This means only consuming foods that you would be able to eat without any teeth.

Genioglossus Advancement

Genioglossus advancement involves pulling forward the tongue muscle that is attached to the lower jaw.

An extremely common cause of sleep apnea is when the tongue rolls back and causes a blockage to the airway, thus interfering with your breathing.

This procedure is often completed alongside hyoid suspension.

The cost of genioglossus advancement ranges between $2,000-$10,000 and the price depends on whether another procedure is required alongside this, e.g. hyoid suspension.

The recovery time for genioglossus advancement is typically 3 weeks. You may be required to stay in hospital for a day or two to ensure you are breathing freely and there is no bleeding. You will need to drink plenty of fluids so as not to risk dehydration and you may be prescribed oral painkillers for any pain.

What Else Do You Need to Know About Sleep Apnea and Surgery?

There are a number of other surgical procedures performed for sleep apnea:

  • Anterior inferior mandibular osteotomy
  • Midline glossectomy and base of tongue reduction
  • Hypoglossal nerve stimulator
  • Lingual tonsillectomy
  • Tracheostomy
  • Laser assisted uvulopalatoplasty

So, as you can see it’s not a one-size-fits-all when it comes to surgery for sleep apnea.

The procedures focus on a number of different body parts (nose, tongue, soft palate, bones of the face, jaw and neck) depending on what is causing your breathing problems when you sleep.

As with any form of surgery, there are certain risks involved with all the sleep apnea procedures, these include:

  • Excessive bleeding
  • An allergic reaction to anesthesia
  • breathing problems
  • infections
  • retention of urine
  • deep vein thrombosis

This is why it’s important to talk to your doctor about your current symptoms and see if there are other forms of treatment you may wish to try first.

You may find that certain lifestyle changes, such as reducing your alcohol intake, quitting smoking, or losing weight could completely cure sleep apnea.

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A solution to sleep apnea could be as simple as sleeping on your side or using extra pillows under your head. Then again, it may involve you wearing a mouth guard, or using a CPAP machine, or some other form of oxygen therapy.

I would suggest that surgery should be your final course of action, but you should always initially consult with a medical professional if you suffer from sleep apnea.

If your doctor informs you that surgery for sleep apnea is the right option for you, they will discuss the various procedures and which one is the best for your particular condition.

Are you considering surgery for sleep apnea?

Or have you undergone one of the procedures described above?

If so, I’d love to hear from you. Please feel free to share your experiences in the comments section below.

Thank you.

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