For some carefully selected people the answer is yes, surgery is a good therapy option for their obstructive sleep apnea (OSA). However the majority of patients with OSA are best treated medically.

Placing a breathing tube in the windpipe (tracheostomy) was the first treatment described for OSA. It was always successful, but was poorly accepted and is seldom used today. Surgeons who specialize in the nose and throat and mouth have subsequently developed a variety of surgical procedures with the goal of altering the shape and/or size and collapsibility of the upper airway so that obstructed breathing events are eliminated. When a clearly obstructing abnormality can be identified, for example kissing tonsils, surgery can be very successful. However this is usually not the case, even using sophisticated imaging techniques. The site of obstruction can be different in different individuals, and there can be more than on site in the same individual. Probably the most frequently done surgery is removal of the uvula (that little hangy-down part you see when you look in your throat) and part of the soft palate and excess tissue on the lateral walls of the throat. This is surgery that hurts a lot, and is not very often successful by itself. More than a dozen other surgical procedures have been tried, alone or in combination. Some of the highest success rates have been described when operations on the nose and throat are combined with surgery to move the lower and upper jaw forward. Unfortunately it is difficult to predict the outcome of surgery for OSA in any one patient. Overall success rates in unselected patients are difficult to evaluate; cure rates of 90% have been reported for some centers doing the most extensive surgery, but these are in small groups highly selected patients. The success rate, depending on the definition of success used, is between 38% and 50% early on, but tends to lessen over time.

If you are considering surgery as a treatment for your sleep apnea you need to be carefully examined by a surgeon and be fully informed of the risks of surgery- including pain, bleeding, and very rarely death – as well as the potential benefits. Patients who choose surgery should be prepared to go all the way to upper and lower jaw advancement.