Dr Jennifer Chow
Specialist in Otorhinolaryngology
I often emphasize to patients that a CPAP machine and effective weight loss should be the primary treatment for sleep apnea. Surgery should only be considered as a supplementary therapy for patients with structural obstruction in their upper airway. Also, surgery only alleviates the condition and does not completely cure it.
Before any operation, we perform an endoscopy on patients to examine the presence of any upper airway blockages due to structural anomalies, focus on multiple problematic areas, and select different surgical procedures. Surgery can be divided into three main categories; causes in the nasal cavity (for example a curved nasal septum, swollen lower nasal turbinate, nasal polyps); reasons in the throat (for example a flabby uvula, enlarged tonsils); and the chin (born short lower jaw, large tongue). In the long run, risks associated with the above operations are low; with the main concern being post-surgery infection of the wound which causes bleeding. If this occurs, usually taking antibiotics by injection in hospital is adequate, or performing another operation to stop the bleeding. After about a week, patient can resume a normal life. As for jaw advancement surgery, this procedure involves inserting metal objects in the jaw. Surgery procedures that involve foreign objects may add complications if infections occur. Remedial surgery will be required to remove the foreign object, but the risks are not high. However, the overall recovery period for jaw surgery maybe longer, on a case by case basis. Since the jaw physically is adjusted, the position of the tongue is altered too. The patient may need to re-adapt oral activities such as speech and eating. Another point to note is that the above operations usually do not require surgical incisions on the face so that no apparent scars will be visible after surgery.
If you do not have structural problems, but sleep apnea was diagnosed, I would still recommend the use of a CPAP machine. Remember not to take suggestions from family or friends candidly, but try using a CPAP machine first to make an informed decision. You may even find that the device will improve overall sleep quality. If the patient flatly refuses to use a CPAP machine, besides effective weight loss, I would recommend using side sleeping pillows which will naturally promote people to sleep on their side. I also propose mouthpieces, which is a non-invasive solution to adjust the position of the lower jaw and improve sleep apnea.