Sleep Apnea Surgery

Sleep Apnea Surgery

What is Obstructive Sleep Apnea?

Obstructive sleep apnea is the occurrence of apneic events (breathing stops) during sleep which leads to low blood oxygen levels. When these apneic episodes occur, the tongue is located against the back of the throat which obstructs the passage of air to the lungs. The primary problem is the collapse of the airway during sleep.

Sleep apnea can be a serious condition with signs/symptoms ranging from sleep deprivation and daytime sleepiness to severe hypoxia during sleep and the potential for associated respiratory and cardiovascular problems. 

What causes Obstructive Sleep Apnea?

There are many factors that may contribute to sleep apnea including:

• Mandibular deficiency: lack of forward suspension of the tongue and associated soft tissues.
• Maxillary deficiency: transverse deficiency (insufficient space to accommodate the tongue) or retruded position of the maxilla and associated soft tissues.
• Deviated Septum: obstructing airflow through the nasal cavity.
• Macroglossia:  enlarged tongue obstructing passage of air.
• Other factors like obesity, alcohol and sedative drugs can aggravate the problem

How is Obstructive Sleep Apnea treated?

The first step is to identify signs of symptoms of sleep apnea and to seek appropriate consultation.  Sleep apnea involves multiple medical and dental implants issues which can be addressed by an Oral and Maxillofacial Surgeon.

In addition to obtaining a detailed history, Dr. Arango will assess the anatomic relationships in the maxillofacial area using the most up to date technology. The workup may include a polysomnography (sleep study), comprehensive physical examination and a CT scan.

There are several treatment options available.  An initial treatment may consist of using a CPAP machine that delivers positive pressure and limits obstruction at night.  Other non-surgical measures are weight loss, jaw positioning devices and positional changes during sleep.

Patients that cannot tolerate their CPAP machine could be candidates for surgical treatment.  Surgical treatment may involve one or more of the following:

• Maxillomandibular advancements: moving the upper and lower jaws surgically to increase the size of the airway.  This surgery has shown a success rate of >96%.
• SARPE (Surgically Assisted Rapid Palatal Expansion) or DOME (Distraction Osteogenesis Maxillary Expansion) procedures to expand the nasopharyngeal airway
• Septoplasty to correct a deviated septum when indicated
• Partial glossectomy to decrease the size of the tongue when indicated.
• The goal of surgery is to expand the airway at the level of the soft palate, base of tongue and hypopharyngeal airway.

• Obstructive sleep apnea is a very serious condition that we, as Oral and Maxillofacial Surgeons, are well-trained to address.

-Most medical insurances offer coverage for diagnosis and treatment of this condition. Dr. Arango is an in network physician with most medical insurance companies.