Surgery as an option to end sleep apnea

Sleep apnea is a disorder in which the sufferer has several episodes of airway obstruction that produce true respiratory pauses (apneas) during deep sleep. This is due to the fact that during certain phases of sleep, all the musculature, including that of the throat, is more relaxed. In the case of patients with this disorder, what happens is that the muscles that should keep the airway open, losing tone, are not able to do so correctly, causing the tongue, soft palate, etc., to fall backwards blocking the airway.

If this situation is prolonged over time, it deteriorates the patient’s quality of life, causes high blood pressure, makes people more susceptible to the development of cardiovascular and cerebrovascular diseases, and many other consequences.

When sleep apnea is intensive, it must be treated directly. Today, the treatment of choice is CPAP, a mask that the patient wears every night constantly during the night’s rest and which blows positive air pressure into the airway, thus preventing collapse. It is an effective measure in most cases, but it can be very uncomfortable and many patients do not tolerate it and abandon the treatment.

However, the only definitive treatment for obstructive sleep apnea is surgery, especially indicated in all those cases that do not tolerate CPAP or in patients who travel a lot and find it difficult to sleep daily with the machine. Two types of surgical techniques can be chosen depending on where the obstruction is located: those that remove tissue where there may be obstruction (tonsils, vegetations, nasal surgery, palate surgery, etc.) or those that widen the continent, i.e., increase the caliber of the airway by displacing structures. In this sense, the most commonly used technique is orthognathic surgery with which we move forward the upper maxilla, the mandible and the musculature of the base of the tongue, in order to leave enough space in the posterior part of the oral cavity to avoid obstruction when the patient sleeps.