Obstructive sleep apnea affects around 20 million Americans and can lead to hypertension, heart attack, stroke, depression, muscle pain, fibromyalgia, morning headaches, and excessive daytime sleepiness.

Friday, February 26, 2010

New surgery to treat obstructive sleep apnea.

There is a new surgery designed to treat sleep apnea. Permanent sutures are placed to secure the tongu to the jaw preventing it from blocking the airway. The is a logic to this procedure and it may require more than 1 surgical procedure. There is no long term data. In general surgery has been ineffective for treating apnea unless major surgical prcedures are done. Soft palate surgery carried high risk of morbidity and poor results. Tongue reduction was more successful,especially base of the tongue reduction. A recent article showed similar rsults with base of tongue reduction and somnoplasty on the base of the tongue. The somnoplasty proceedure had lower risk and morbidity.

CPAP remains the "Gold Standard" for treatment of obstructive sleep apnea but the majority of patients do not tolerate CPAP or BiPAP. Oral appliances are the only other therapy considerd a first line treatment of mild to moderate sleep apnea. Oral Appliances are considered an alternative treatment for severe sleep apnea when patients do not tolerate CPAP. Even when sleep apnea is severe the majority of patients do not tolerate CPAP.

Bimaxillary advancement is the most successful surgical proceedure but is a major orthopedic procedure with significant risks of morbidity. The surgery works in a similar method to oral appliances. Prior to surgery a trial oral appliance can help determine the best position to place the jaws to prevent additional future surgeries.

Suturing the tongue to the jaw is a novel approach to treating sleep apnea. Hopefully it will be more successful and less painful that soft palate surgery has proven to be.

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posted by Dr Shapira at 12:30 PM