Surgical Treatment of Obstructive Sleep Apnea Syndrome

Chung, Yoo-Sam

doi:2015.89.1.27

Korean J Med > Volume 89(1); 2015 > Article

Special Review

호흡기

The Korean Journal of Medicine 2015;89(1):27-34.
Published online July 1, 2015.
DOI: https://doi.org/10.3904/kjm.2015.89.1.27

Surgical Treatment of Obstructive Sleep Apnea Syndrome

Yoo-Sam Chung

Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

폐쇄성 수면 무호흡증의 외과적 치료

정유삼

울산대학교 의과대학 서울아산병원 이비인후과

Correspondence:
Yoo-Sam Chung, Tel: +82-2-3010-3710, Fax: +82-2-489-2773, Email: yschung@amc.seoul.kr

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Continuous positive airway pressure (CPAP) has proven very effective in the treatment of adult obstructive sleep apnea syndrome (OSAS). However, the CPAP device must be used every day and is associated with some discomfort. As a result, many patients do not comply with physician-recommended CPAP usage. Surgical intervention for OSAS eliminates issues with patient non-compliance. Although it is less effective than CPAP, surgery represents a feasible alternative for patients who are non-compliant with CPAP usage, have mild to moderate OSAS without significant comorbidities, or suffer from simple snoring. Nasal surgery can also reduce an individual’s CPAP pressure requirement and thus increase compliance. Of the various surgical procedures available, uvulopalatopharyngoplasty, which removes excess tissue from the soft palate and pharynx, is successful only in selected patients, while multilevel surgery is more effective. For example, maxillomandibular advancement is promising, although it is associated with potential morphological change in the airway. Radiofrequency ablation and palatal implants are minimally invasive interventions for simple snoring and mild OSAS. In morbidly obese patients, bariatric surgery has proven particularly effective. Finally and most recently, surgically implanted devices that stimulate the hypoglossal nerve have been investigated.

Key Words: Surgical procedures, Operative; Sleep apnea, Obstructive

주제어: 수술; 폐쇄성 수면 무호흡증