Surgical treatment for sleep apnea

Content

  • Types of surgery
  • What uvulopalatofaringoplastika (UPPP)
  • Possible complications during and after surgery



  • Types of surgery

    Removing enlarged tonsils and adenoids, which may violate the airway lumen. This is especially true in children.

    Uvulopalatofaringoplastika - This operation is excision of the tonsils, uvula (the tissue folds, which hangs in the middle of the back of the soft palate) and part of the soft palate.

    Laser uvuloplastika - This operation is very effective in the treatment ofsnoring, but for the treatment of sleep apnea syndrome, it is not necessary. The intervention is excision with laser uvula and part of the soft palate. Since this operation helps to eliminate the most important sign of sleep apnea - snoring before surgery is recommended to explore the nature of sleep.

    Tracheostomy - This method is used in severesleep apnea syndrome. The trachea is a small hole in it and inserted tube. Thus air flows to the lungs through the tube. The results of this operation is quite successful, but it is applied only in those patients in whom other treatments are ineffective.

    Other methods of surgical treatment of sleep apnea:

    • Plastic surgery on the lower jaw, designed to change its shape.
    • Surgery on the nose: eg turbinektomiya (surgery is to remove one of the turbinates), septoplasty (surgery aimed at removing the nasal septum defects), and others.
    • Surgical treatment of obesity.



    What uvulopalatofaringoplastika (UPPP)

    UPPP - a procedure aimed at removingexcess soft tissue of the mouth (soft palate, pharynx, tonsils) in order to expand the lumen of the respiratory tract. It is used to relieve the air permeability in the treatment of obstructive sleep apnea syndrome type.

    Surgical treatment for sleep apnea Usually when UPPP excised following elements:

    • Tongue - the section of the soft palate, which is located at the middle of the back of it and hangs down.
    • Some of the soft palate.
    • Excessive throat tissue, tonsils and adenoids.

    If the main cause of obstructive typesleep apnea syndrome is an enlarged tongue, the surgeon excised small fragment. In this case, the operation is called uvulopalatofaringoglossoplastika.

    The operation is usually performed under general anesthesia. After the surgery may require continued use of continuous positive airway pressure (CPAP), which facilitates breathing during sleep and prevents spadenie airways. Some painkillers cause relaxation of airway muscles. Therefore, after the operation is to avoid the use of such funds for the prevention of apnea episodes. These medications include narcotic painkillers (Promedolum, morphine).

    UPPP procedure is chosen as a method of treatment of sleep apnea syndrome in:

    • Presence of excess of soft tissue in the nasal cavity, mouth, throat, causing choking.
    • In case of failure or reluctance to the use for the treatment of continuous positive airway pressure (CPAP).
    • In case of failure of the above-mentioned method (CPAP).
    • If you do not want to resort to tracheostomy surgery.

    Children usually do not apply UPPP. For them, more often than not it is sufficient that a tonsillectomy or adenoidectomy.

    It should be remembered that the UPPP can fullyeliminate snoring, but the patient may continue to suffer sleep apnea syndrome. Some studies worldwide indicate that UPPP procedure yielded positive results in the treatment of 40 - 60% of patients. However, even with the positive results of surgery, the patient may feel the need for the use of continuous positive airway pressure (CPAP).



    Possible complications during and after surgery

    Complications during surgery include accidental damage to the surrounding soft tissue and blood vessels.

    Postoperative complications may include:

    • Sleepiness and episodes of apnea as a result of the use of pain medication after surgery.
    • Swelling in the area of ​​the surgical wound, pain, infectious complications and bleeding.
    • Problems with speech. After surgery, the patient can speak as if "through the nose".
    • Narrowing of the airways of the nose level.

    It should be noted that before deciding onsurgery, it is worth to try to try conservative treatment, namely continuous positive airway pressure (CPAP). After the operation UPPP should conduct a study on the nature of sleep (polysomnography) to determine whether the positive results observed operations. If after surgery, you will still experience episodes of apnea, should continue to conservative treatment.

    In recent years, increasingly used laseruvuloplastika. This operation is different from the normal UPPP in that it is more economical and safer. It is based on the fact that the laser is a kind of "vaporizes" the edge of the soft palate and uvula. Unlike UPPP uvuloplastiki laser procedure may require re-implementation in order to achieve a better result. The number of procedures can be up to four. During this procedure also removes the tonsils. Although laser uvuloplastika is characterized by a smaller number of postoperative complications, pain after surgery remains moderate.

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