Surgical snoring and sleep apnea treatment
Snoring is not only a social, but also serious medical problem negatively affecting the health and quality of life of both the person who snores and his/her bed partner. Therefore, not only the person who snores, but also his/her close people, often seek medical advice and help because of this problem.
The literature widely describes a serious health and even life threat that can be caused by snoring.
If a person who snores experiences difficulty to sleep at night, suffers from daytime sleepiness, experiences difficulty to concentrate, and is overweight, obstructive sleep apnea syndrome (OSAS) can be suspected. Although this syndrome is common and affects one in every 50 adults on the average, it should be considered a potentially life-threatening condition that has to be treated. The patient with suspected OSAS has to be thoroughly examined, and when the diagnosis is confirmed, an appropriate treatment – surgical or conservative – should be initiated.
The symptoms are caused by the excess tissue in the mouth (soft palate) and/or the throat (tonsils, uvula).
The diagnostic procedure involves 2 approaches: polysomnography and examination of the nose and the throat with a flexible endoscope.
- Polysomnography is a diagnostic test that is performed while the patient is asleep. During this study, the length of snoring and the frequency of episodes of breathing cessation are recorded.
- During the endoscopic examination, the narrowest place in the upper airways, which causes snoring, is determined.
How it Is Treated?
Once OSAS is diagnosed in patients with overweight, they will be firstly advised to loose weight.
The most effective method for the treatment of snoring and sleep apnea is a surgical approach. It involves several surgical procedures: uvulopalatopharyngoplasty and radiofrequency or laser-assisted thermal ablation palatoplasty.
Uvulopalatopharyngoplasty is a surgical procedure during which an excess tissue in the throat is removed. The airways thus become open, and airflow more easily passes to the lower airways.
How Is the Surgery Performed?
The surgery is performed under general anesthesia, and it usually takes 1.5 hours to complete.
During the procedure, the palatine tonsils and part of the soft palate and the uvula are removed. An uvulopalatal flap from the excess mucosa of the uvula and the soft palate is formed; it is lifted up and attached to the soft palate with self-dissolving stitches. This procedure lifts the soft palate upward leading to more space behind the palate; and thus the air passage is restored. In order to fix the lateral pharyngeal walls, the anterior and posterior pharyngeal pillars are sutured back together at the end of the procedure.
What Should Be Known After Surgery?
- Physical activity should be restricted for 1 week after the procedure;
- The patient should follow a special diet: eating fruits (except bananas), honey, and chocolate as well as drinking carbonated beverages and fruit juices are discouraged; soft food is recommended;
- The patient should refrain from smoking for 2 weeks; frequent coughing or expectorating should be avoided;
- Pain can be experienced for about 3 weeks;
- The patient can suffer from altered voice for about 6 weeks;
- The outcome of the procedure is seen when the surgical wounds heal completely and swelling of the soft palate subsides (approximately after 3–4 weeks).