Treatment of Obstructive Sleep Apnea

There are several treatment options available. An initial treatment may consist of using a nasal CPAP machine that delivers pressurized oxygen through a nasal mask to limit obstruction at night. For many patients, this is a great solution. There is no surgery or procedures necessary. You just put on the mask each night when you go to sleep.The CPAP machine actually forces the flow of air and prevents the tissues from collapsing.

For some patients, CPAP therapy is not effective. For others, the cumbersome mask required each time they go to sleep is something they cannot or are unwilling to tolerate. Conditions such as claustrophobia prevent some patients from being able to wear a mask on their face. If CPAP isn’t working or it’s just not right for you, there are other options available.

Dr. Colgan is a board-certified Oral and Maxillofacial Surgeon trained in the surgical treatment of obstructive sleep apnea.There are several procedures and surgical procedures available to treatOSA. The choice of procedure depends on several factors including anatomy and severity of level of sleep apnea. While not always the case, a general rule is the more severe the sleep apnea, the more anatomy levels are involved that require treatment before the OSA can be cured.

Sometimes nasal surgical procedures to correct a deviated septum or reduce enlarged tissues in the nose are done to improve breathing through the nose and help to tolerate the CPAP mask better.

The Pillar Procedure can be used to stiffen the soft palate in some patients as a treatment for their OSA. The PillarProcedure has been studied and shown to be successful in treating mild and moderate OSA. The Pillar Procedure can be the only treatment necessary in some mild OSA patients. In other patients with more significant OSA, the Pillar Procedure can be used in combination with other procedures treating other levels of the airway for the best likelihood of curing OSA.

Uvulo-palato-pharyngo-plasty (UPPP), is a surgical procedure where tissue of the soft palate and uvula are removed. At the same time, tonsils are removed if still present in an adult with OSA and the airway widened by suturing the remaining tonsil tissue to the side of the airway. This surgical procedure has some good results, but is most likely done in conjunction with other levels of anatomy to achieve the best results and likelihood of cure.

TongueBase Surgical Procedures include:

Genioglossal Advancement of the very back of the tongue (below any area you can see or touch) by pulling the muscle attachments at the chin forward. This procedure can be performed in approximately 30 minutes. The results of this surgery are excellent in patients with collapse of their tongue into the airway.

Tongue Suspension of the very back of the tongue base is performed by using a screw and permanent suture attached to it which is triangulated through the base of the tongue preventing it from collapsing into the airway during sleep. This procedure has excellent results in curing OSA in combination with other procedures at other levels of the airway.

HyoidSuspension is a surgical procedure where the hyoid bone in the front of the neck is suspended upwards to the mandible.The hyoid bone has muscles from the base of tongue attached to it. Advancing this small bone brings the tongue base forward opening up the distal airway and preventing collapse during sleep.This procedure is used in treating patients with tongue base collapse and can be done in conjunction with procedures treating other levels of the airway for the best likelihood of curing OSA.

In more complex cases, the bones of the upper and lower jaw may be repositioned to increase the size of the airway (orthognathic surgery). This procedure is done in the hospital under general anesthesia and requires a one to two-day overnight stay in the hospital.

OSA is a very serious condition that needs careful attention and treatment. Every patient’s anatomy is different resulting in different procedures necessary to cure their OSA. Only a full examination by a doctor specializing in the surgical treatment of OSA can determine what procedures are best for you.

Dr. Colgan will discuss the best treatment solutions for you and develop a customized treatment plan based on your anatomy.

To schedule a consultation with Dr. Colgan to treat your OSA, call our office in Vero Beach, FL at 772-770-9191