If you have obstructive sleep apnea (OSA) and surgical options are being considered, the key to having the best possible outcome from surgery is to address all levels of obstruction whether at the nose, mouth, and tongue levels. The same is true for patients with severe snoring desiring surgical options. The proper surgery required depends on where the snoring is coming from... The nose? Uvula? Tongue???
Unfortunately, in some patients, it is hard to determine the anatomic area responsible for obstruction (or snoring) while awake. Clearly while awake, there are no symptoms and an examination in this awake state will often be unrevealing.
This is where a procedure called sedated (or sleep) endoscopy can be quite helpful
Surgery to Correct
Adenoidectomy for adenoid hypertrophy Septoplasty for deviated septum Turbinate Reduction for turbinate hypertrophy
ORAL CAVITY LEVEL
Tonsillectomy for tonsillar hypertrophy Uvulopalatopharygnoplasty (UPPP) for uvulo-palatal hypertrophy and retro-lingual collapse Mandibular-maxillary advancement
Base of tongue reduction Lingual Tonsillectomy Thyro-Hyoid Advancement (THA) Repose Procedure (Genio-glossal advancement) (GA) Genio-hyoid advancement (GHA) Mandibular-maxillary advancement (MMA) Sleep endoscopy is a special procedure to determine exactly where an upper airway obstruction is localized causing obstructive sleep apnea or snoring WHILE A PERSON IS SLEEPING. There are two distinct components to this procedure. 1) Endoscopy is when a thin flexible camera is inserted through the nose in order to examine the entire upper airway from the tip of the nose to the voicebox. 2) Sleep (or sedated) endoscopy is when the endoscopy is performed while a patient is sleeping instead of wide awake as traditionally performed. Given most patients will immediately wake up if a doctor is inserting something into the nose (as well as most doctors will not wait for a patient to fall asleep at night in order to perform this procedure), the patient is sedated by an anesthesiologist using IV medications.