Surgery is the of benefit if there is obstruction in the airway. This can be categorised according to the various parts of the air passage.
- Nasal Surgery
Nasal obstruction causes increase in airway resistance of teh collapsible part of the airway promoting upper airway collapse. This results in mouth breathing which pushes the tongue back posteriorly narrowing the oropharynx (mouth) and also the area behind the tongue. Nose blockage also decrease the stimulus to breathing (nasobronchial reflex)
Widening of the nasal passage will reverse some of this situation. In general, this would involve the realignment of the nasal septum and reduction of the size of the turbinate. (Please click on this link for a description)
- Tonsil and Palatal Procedures
If the tonsils are enlarged and the palate is floppy, this can further cause narrowing of the airway. The situation is worse when one lies on the back. The tongue and tonsils will move backwards and the oropharynxx narrowed.
Reduction of the size or complete removal of the tonsils will greatly enlarged the tonsils. This can be performed using a variety of techniques. I prefer the use of coblation in removing or reducing the size of the tonsils. This is less traumatic and allows faster recovery as less heat is generated during the procedure. (See Coblation Tonsillectomy)
Palatal flutter which is a significant cause of snoring can be reduced by palatoplasty (removal of some parts of the palate) or palatal stiffening which I perform using coblation to cause the shrinkage of the palate and pulling it forward.
Read more about Tonsils
- Tongue Base Surgery
The tongue base with can be enlarged and cause airway blockage when one lies down. Due to the location, this has been a difficult area to operate on. With advances in equipment, the tongue base can be reduce by coblation channelling, coblation reduction of the lingual tonsils and the use of robotic assisted surgery.
4 . Jaw Surgery
This would involves advancement of the maxilla bone and mandibular a major procedure