If you have been diagnosed with sleep apnea consider yourself lucky, in a way, because most of the time, the condition remains undiagnosed. In case your doctor has advised surgery for sleep apnea, your condition ought to be serious, or else, doctor would have opted for other non-interventional treatment methods.
Considering that there are plenty of surgical options available for treating the condition, you must be wondering which of these would be selected and why. First of all, the choice of surgery entirely depends on the site of obstruction in the respiratory tract, which includes the nose, throat and tongue. Since the nature of the airways as well as seriousness of the condition varies widely, at times, doctors prefer using a combination of several surgeries to achieve the desired result.
The typical sites of obstruction
Other than obesity, nasal obstruction is one of the common causes for onset of the condition. Three anatomic areas within the nasal cavity that results in impaired breathing are deviated septum, enlarged turbinates, and the nasal valve.
The chosen therapy
As mentioned earlier, choice of surgery depends on the location of obstruction. In this regard, the somnoplasty procedure is the only surgical option that uses temperature-controlled radiofrequency energy (TCRF) to reduce, control and tighten enlarged tissues in the upper airway tract like the tonsils, nasal passages, palate and base of tongue.
It has been reported that more than 50% leading otolaryngology teaching institutions now support this technology that was originally developed by Somnus Medical Technologies. The procedure received FDA approval in 1997 for the treatment of habitual snoring and upper airway resistance syndrome.
The procedure
It involves piercing relevant sections of the area (tongue, nasal cavity, throat or soft palate) where the obstruction is located with the help of a pre-heated single-use, disposable electrode, called the Somnus device. The principle of the procedure is to apply low levels of radiofrequency of thermal energy at approximately 85° C (185° F) to create finely controlled coagulative lesions. This scarring of the relevant tissues not only causes volume reduction but also stiffening of the excess tissues thereby clearing the air passage to allow obstruction-free breathing.
The body subsequently absorbs the burnt tissues over the next 3 to 8 weeks. However to achieve desired results, the patient might have to undergo 3 to 5 such procedures.
When treating sleep apnea, the surgery is done under local anesthesia at the outpatient clinic of an ENT surgeon and does not take beyond 30 to 45 minutes. An extra 5 to 10 minutes might be required for heating the electrode to the right temperature.
Who is the right candidate for this surgery?
It is imperative that the sleep disorder be correctly diagnosed. This is because sleep apnea may at times be mistaken for narcolepsy or hypersomnia, because of certain overlapping of symptoms. For example, excessive daytime sleepiness is a common sign shared by several sleep problems.
Therefore, it is necessary to undergo polysomnography as well as Multiple Sleep Latency Test to confirm the presence of sleep apnea, assess the severity as well as identify the likely sites of obstruction before this type of surgery for sleep apnea is regarded as the best choice.
