Korean J Med.  2015 Jul;89(1):27-34. 10.3904/kjm.2015.89.1.27.

Surgical Treatment of Obstructive Sleep Apnea Syndrome

• Chung YS

• KMID: 2269046
• DOI: http://doi.org/10.3904/kjm.2015.89.1.27

Abstract

Continuous positive airway pressure (CPAP) has proven very effective in the treatment of adult obstructive sleep apnea syndrome (OSAS). However, the CPAP device must be used every day and is associated with some discomfort. As a result, many patients do not comply with physician-recommended CPAP usage. Surgical intervention for OSAS eliminates issues with patient non-compliance. Although it is less effective than CPAP, surgery represents a feasible alternative for patients who are non-compliant with CPAP usage, have mild to moderate OSAS without significant comorbidities, or suffer from simple snoring. Nasal surgery can also reduce an individual's CPAP pressure requirement and thus increase compliance. Of the various surgical procedures available, uvulopalatopharyngoplasty, which removes excess tissue from the soft palate and pharynx, is successful only in selected patients, while multilevel surgery is more effective. For example, maxillomandibular advancement is promising, although it is associated with potential morphological change in the airway. Radiofrequency ablation and palatal implants are minimally invasive interventions for simple snoring and mild OSAS. In morbidly obese patients, bariatric surgery has proven particularly effective. Finally and most recently, surgically implanted devices that stimulate the hypoglossal nerve have been investigated.

Keyword

Surgical procedures, Operative; Sleep apnea, Obstructive

MeSH Terms

Adult
Bariatric Surgery
Catheter Ablation
Comorbidity
Compliance
Continuous Positive Airway Pressure
Humans
Hypoglossal Nerve
Nasal Surgical Procedures
Palate, Soft
Patient Compliance
Pharynx
Sleep Apnea, Obstructive*
Snoring
Surgical Procedures, Operative