Can surgery cure sleep apnea? (Serial I)

Nowadays, OSAHS (commonly known as snoring) is getting more and more attention as the source of many diseases (hypertension, diabetes, heart and brain diseases, etc.). In outpatient clinics, I often hear patients ask if OSAHS can be operated? What kind of surgeries are available? Here I would like to briefly introduce some of the problems of OSAHS surgery. OSAHS is a sleep apnea disorder caused by obstruction or collapse of the upper airway. The upper airway includes the nasopharynx, oropharynx, and laryngopharynx, and obstruction anywhere in these areas can lead to OSAHS. Therefore, determining the site of obstruction is the key to the success of the surgery, which is why before the surgery the surgeon must not only perform polysomnography (qualitative examination) but also a series of localization examinations (e.g. muller endoscopy, esophageal manometry, nasopharyngeal airway, nasoacoustic reflex, x-ray cephalometrics and a series of other examinations). The aim is to find the site and cause of the obstruction and target the treatment. Once the site of obstruction is found, surgery can be targeted. Since there are many anatomical structures in the upper airway, there are different surgical procedures involved, such as nasal stenosis, which can be selected from nasal dilatation surgery and nasopharyngeal adenoid hypertrophy resection. For stenosis in the oropharynx, we can choose between hard palate truncation, soft palate advancement surgery, Pillar stent implantation, and classic hanging palatopharyngoplasty. Stenosis in the posterior region of the tongue can be treated with plasma knife ablation of the root of the tongue, plasma knife reduction of the tongue, partial excision of the root of the tongue, Repose hyoid suspension of the root of the tongue, anterior mandibular reshaping, and mandibular distraction osteosynthesis, to name a few. Due to the different areas and degrees of obstruction, it can be said that each patient’s treatment plan is not quite the same, which we call personalized treatment. Therefore, we ask our patients to have some patience, only when we find the exact cause of the disease, the treatment will have satisfactory results, which is also the wish of our doctors.