Obstructive sleep apnea occurs due to airway impediment during sleep. Various medical researches show that children and adults with this problem mostly have smaller airway or floppy airway that has a tendency to collapse unlike individuals with no obstructive sleep apnea and therefore they require surgery. The airway constitutes lower and upper jaw, tonsils, soft palate, tongue and sidewalls of the throat. Surgery is used to manage this condition by enlarging the airways through the removal of soft tissues. In addition, jaw structures that restrict airway are expanded through this procedure. Further, it reduces the laxity of the upper airway and thus easing the obstruction. It is important to note that various procedures and medical concepts have been developed to take care of different anatomies. This is due to the fact that airway structures of children and adults vary greatly.

Sleep apnea surgery success rate depends on individual patient’s airway pattern and the severity of sleep apnea obstruction. What is notable is that as the severity of obstructive sleep apnea get more complicated, so does the invasiveness of the needed surgery that helps in achieving successful surgical outcome. Clearly, before any procedure is carried out, diagnosis of (OSA) based on patients sleeping study is crucial, although some medical practitioners disputes the importance of formal polysomnography, but the use of ambulatory sleep study is acceptable practice under the current standards. The surgical procedure to be used in any surgery is influenced by various factors. For instance, patient`s preference and desire coupled with the health status can undoubtedly influence outcomes and thus they must be put into consideration.

Additionally, the aim of surgery differs from one patient to another. Many patients prefer surgery owing to their intolerance to nonsurgical treatments. Other patients prefers surgery to enable them tolerate non surgical treatments like the reduction of therapeutic pressure. Thus, the endpoint needs to be discussed between the surgeon and the patient before the commencement of the surgery alongside the surgical success criteria. The patient needs to be educated in regards to the rationale of the procedure and the associated benefits and risks. There are various surgical options available for patients with obstructive sleep apnea. These options include uvulopalatopharyngoplasty (UPPP), tracheotomy, and maxillomandibular expansion and uvulopalatal flap.

Uvulopalatopharyngoplasty (UPPP) is a common surgery that is used to treat patients with moderate and mild obstructive sleep apnea (OSA) who cannot take other medical management options for this condition. UPPP helps to surgically remove excessive tissues in the upper airway that includes the back of throat and month. These tissues are the ones that obstruct the airway and thus, their removal clears the airway obstruction.

Tracheotomy refers to surgical incision made in front of the trachea (windpipe) with insertion of a plastic tube on it in order to keep it open. This type of operation is highly effective in managing and treating this problem. Maxillomandibular Expansion is an operation that involves the widening of the lower and the upper jaws in order to improve the airway. During this operation, jaws are weakened temporarily by a limited cut on the bone. A distracter which is an orthodontic device is placed between the jaws during the operation in order to incrementally expand the jaws. Uvulopalatal flap is a common operation procedure that is used to treat soft palate. The procedure involves the removal of tissues from the palate or the back walls of the throat in order to increase the size of airways. The procedure involving uvulopalatal flap procedure is less invasive that greatly achieves the patient’s improvement in their airways.

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