Sleep Apnea Surgery

Causes of Sleep Apnea

The main causes of sleep apnea include the following:

• Upper Respiratory Tract Obstructions: Relaxation of the throat muscles, large tonsils, adenoid enlargement, tongue root enlargement and sagging of the soft palate can cause airway obstruction.
• Obesity: Excess weight can lead to fat accumulation around the neck, narrowing the airway.
• Genetic Factors: Family history of sleep apnea, narrow airway structure or anomalies in the jaw structure may predispose to sleep apnea.
• Nasal Obstructions: Problems such as nasal curvature (deviated septum), nasal polyps and chronic sinusitis can also affect airway patency.
• Age and gender: With aging, the throat muscles weaken and the risk of airway obstruction increases.
  Sleep apnea is more common in men than in women.

Symptoms of Sleep Apnea

Sleep apnea manifests itself with various symptoms both during sleep and during the day:

• Loud Snoring: The most common symptom of sleep apnea is loud snoring, especially when lying on your back.
• Respiratory Stoppages: Short-term cessation of breathing during sleep, frequent awakenings during sleep and a feeling of breathlessness may occur.
• Fatigue throughout the day: Due to poor quality and interrupted sleep, the person experiences fatigue, weakness and drowsiness throughout the day.
• Headache People with sleep apnea may wake up with a headache in the morning.
• Concentration and Memory Problems: Insufficient oxygen intake during sleep can lead to impaired mental functioning.

Sleep Apnea Diagnosis

The patient’s sleep patterns, complaints and physical examination are important in the diagnosis of sleep apnea.
Methods used to make a diagnosis:

• Sleep Test (Polysomnography): Polysomnography performed in a sleep laboratory measures the patient’s brain waves, heart rhythm, respiratory movements, oxygen levels and body movements during sleep.
  This test is the gold standard for determining the presence and severity of sleep apnea.
• Physical Examination: The structure of the upper respiratory tract, the condition of the nose, throat and jaw are examined and possible obstructions are examined.
• Endoscopy Endoscopic examination of the nose and throat can be performed to determine where the airway is blocked during sleep.

Suitable Candidates for Sleep Apnea Surgery

Sleep apnea surgery is performed especially when obstructive sleep apnea does not respond to non-surgical treatments (CPAP device, oral appliance, lifestyle changes) or when anatomical defects need to be corrected.
Suitable candidates for surgical intervention:

• Moderate and severe sleep apnea patients who do not benefit from other treatment methods.
• Those with large tonsils or adenoids.
• People with breathing difficulties due to nasal congestion or deviated septum.
• Patients with structural disorders of the airway (narrow airway, large tongue root).

Types of Sleep Apnea Surgery

In the surgical treatment of sleep apnea, various surgical methods are used to remove obstructions in the airway.
The main types of sleep apnea surgery:

1. Uvulopalatopharyngoplasty (UPPP)

In this surgical procedure, part of the drooping and loose soft palate, small tongue (uvula) and excess throat tissue are removed to improve airway patency.
UPPP is especially preferred in cases where the soft palate and small tongue cause sleep apnea.

2. Adenoid and Tonsil Surgery

One of the most common causes of sleep apnea, especially in children, is large tonsils and adenoids.
Surgical removal of tonsils and adenoids (adenotonsillectomy) helps to improve the symptoms of sleep apnea by opening the airway.

3. Tongue Root Surgery

The root of the tongue can block the airway during sleep, causing sleep apnea.
Surgical procedures such as tongue root reduction or pulling the tongue muscle forward increase airway patency.

4. Septoplasty and Concha Surgery

A deviated septum and enlarged nasal meatus (turbinates), which cause nasal congestion, can worsen the symptoms of sleep apnea.
Septoplasty and turbinate reduction surgeries facilitate breathing by opening the nasal airway.

5. Jaw Advancement Surgery (Maxillomandibular Advancement)

In this procedure, the upper and lower jaw are moved forward to widen the airway.
This surgery can be effective in people with narrowing of the airway due to disorders in the jaw structure.

6. Implantable Devices (Hyoid Suspension)

In this method, implantable devices are used to prevent the tongue and soft palate from obstructing the airway during sleep.
Hyoid suspension keeps the airway open by pulling the tongue root forward.

Recovery After Sleep Apnea Surgery

The recovery process after sleep apnea surgery varies depending on the type of surgical intervention performed.
Points to be aware of:

• Pain and discomfort: After surgery, there may be pain and discomfort in the throat, nose or jaw area.
  This will subside within a few days.
• Nutrition: Soft and liquid foods should be consumed in the first days.
  In throat surgeries, hard and spicy foods that may cause irritation should be avoided.
• Medication Use: Painkillers and antibiotics recommended by the doctor should be used to prevent pain and infection.
• Activity Restriction: Heavy exercises and physical activities should be avoided in the first weeks.
  It is important to protect the surgical site.

Risks and Side Effects

Although sleep apnea surgery is a safe procedure when performed in expert hands, it may have some risks and side effects:

• Bleeding Bleeding may occur after surgery, especially after surgical procedures in the throat area.
• Infection There is a risk of infection after surgery.
  To reduce this risk, postoperative care instructions should be followed.
• Voice Change Surgical procedures on the soft palate or root of the tongue may rarely cause a change in voice tone.
• Ineffectiveness of Surgery: Given the severity of sleep apnea and the location of the obstruction, surgery may not always offer a complete solution.
  In some patients, sleep apnea symptoms may not improve completely after surgery.