Archive for 'Surgery'
Sleep Apnea Surgery
Some sleep apnea patients may need surgery to remove excess tissue from the nose or throat (removal of adenoids and tonsils, nasal polyps or other growth) and to straighten a deviated septum. Although surgery is an excellent way of treating symptomatic sleep apnea, its success rate is low. Therefore, surgery should be reserved for those patients who have not responded to other therapeutic interventions. Usually, more than one surgical procedure is attempted to realize the benefits.
Uvulopalatopharyngoplasty (UPPP) is the most common surgery to treat sleep apnea. It intends to enlarge the airways by removing all redundant tissue (tonsils, adenoids, uvula) from the pharynx. The overall success rate is 30 to 50 percent.
Laser-assisted Uvulopalatoplasty (LAUP) can be performed in a specialist’s office and involves the use of a laser to remove part of the soft palate, shorten the uvula (the uvula is the tissue that hangs from the middle of the back of the roof of the mouth) and remove other excess tissue from the pharynx. However, the effectiveness of LAUP in treating sleep apnea has not yet been proven.
Tracheostomy is absolutely successful but is very invasive, both physically and psychologically and therefore is generally reserved for patients with severe life threatening sleep apnea. In this procedure, a small hole is made in the trachea or windpipe below the site of obstruction and a tube is inserted into the opening. This tube is opened only during sleeping hours, so that air flows directly into the lungs, bypassing any blocked air passage in the throat.
Other surgical procedures include radiofrequency ablation (RFA), which makes use of radiofrequency energy to remove tissue from uvula, soft palate and tongue and thereby help treat sleep apnea. In children and adolescents removal of enlarged tonsils or adenoids stands as a viable option in the treatment of sleep apnea.
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Obstructive Sleep Apnea
Obstructive sleep apnea is a condition characterized by recurrent hypoxemia and arousal, due to partial or complete obstruction of the upper airways during sleep with consequent daytime somnolence.
Symptoms are loud snoring, hypersomnolence (excessive daytime sleepiness), and restless sleep. Other symptoms of obstructive sleep apnea include choking or gasping during sleep, unrefreshing sleep, morning headaches, daytime fatigue, personality changes, memory impairment, impaired concentration, poor judgment, mood disturbances, recent weight gain, polyurea, and impotence.
The goal of treatment for sleep apnea patients is to keep the airway open and prevent pauses in breathing during sleep.
Methods to alleviate sleep apnea include behavioral measures such as avoiding alcohol and CNS depressants close to bedtime, weight reduction and sleep posture modification.
Continuous Positive Airway Pressure (CPAP) works by gently blowing pressurized air through the nasal passage of the patient at a pressure high enough to prevent the throat from collapsing during sleep.
Oral or dental appliances reposition the lower jaw and the tongue, opening up the space at the back of the throat, and helping treat sleep apnea.
Uvulopalatopharyngoplasty (UPPP)
Which is the most common type of surgery to treat sleep apnea, enlarges the airway by removing redundant tissue (tonsils, adenoids, uvula) from the pharynx.
Laser-assisted Uvulopalatoplasty (LAUP), which can be performed in a specialist’s office involves the use of a laser to remove part of the soft palate, shorten the uvula (the tissue that hangs from the middle of the back of the roof of the mouth) and remove other excess tissue from the pharynx.
Tracheostomy is a procedure in which a small hole is made in the trachea or windpipe below the site of obstruction and a tube is inserted into the opening. This tube is opened only during sleeping hours, so that air flows directly into the lungs, bypassing any blocked air passage in the throat.
Another relatively new procedure is radiofrequency ablation (RFA), which makes use of radiofrequency energy to remove tissue from uvula, soft palate and tongue and thereby help treat sleep apnea. In children and adolescents removal of enlarged tonsils or adenoids stands as a viable option in the treatment of sleep apnea.
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Sleep Apnea
Sleep apnea is a breathing disorder characterized by episodes of disturbed or interrupted breathing during sleep associated with recurrent arousals and awakenings.
The cessation in breathing (interruption) during sleep lasts for 10-30 seconds in patients with mild-to-moderate sleep apnea. However, in severe cases this cessation may last for even three minutes. It is estimated that in United States alone, over 12 million people suffer from sleep apnea.
There are two types of sleep apnea, obstructive sleep apnea characterized by recurrent hypoxemia and arousal and Central sleep apnea caused due to problem with signals from the brain that control breathing.
The cardinal symptoms of sleep apnea are loud snoring, hypersomnolence (excessive daytime sleepiness), and restless sleep. Other symptoms of sleep apnea include choking or gasping during sleep, unrefreshing sleep, morning headaches, daytime fatigue, personality changes, memory impairment, impaired concentration, poor judgment, mood disturbances, recent weight gain, polyurea, and impotence.
The goal of treatment for sleep apnea patients is to keep the airway open and prevent pauses in breathing during sleep. Various methods are used to alleviate sleep apnea including Behavioral Therapy such as avoiding alcohol and CNS depressants close to bedtime, weight reduction and sleep posture modification.
Continuous Positive Airway Pressure (CPAP) works by gently blowing pressurized air through the nasal passage of the patient at a pressure high enough to prevent the throat from collapsing during sleep.
Oral or dental appliances reposition the lower jaw and the tongue, thus opening up the space at the back of the throat, and helping treat sleep apnea.
Uvulopalatopharyngoplasty (UPPP)
UPPP, the most common type of surgery to treat sleep apnea, enlarges airways by removing redundant tissue (tonsils, adenoids, uvula) from the pharynx.
Laser-assisted Uvulopalatoplasty (LAUP) can be performed in a specialist’s office and involves the use of a laser to remove part of the soft palate, shorten the uvula (the tissue that hangs from the middle of the back of the roof of the mouth) and remove other excess tissue from the pharynx.
Tracheostomy is a procedure in which a small hole is made in the trachea or windpipe below the site of obstruction and a tube is inserted into the opening. This tube is opened only during sleeping hours, so that air flows directly into the lungs, bypassing any blocked air passage in the throat.
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