Thomas Verse1, Karl Hörmann. 1. Abteilung für HNO-Heilkunde, Kopf- und Halschirurgie, Asklepios Klinik Harburg, Eißendorfer Pferdeweg 52, D-21075 Hamburg.
Abstract
BACKGROUND: Obstructive sleep apnea (OSA) is a very common disorder among adults: the prevalence of mild OSA is 20%, and that of moderate or severe OSA is 6% to 7%. Simple snoring is even more common. Conservative treatments such as nocturnal ventilation therapy and oral appliances are successful as long as the patient actually uses them, but they do not eliminate the underlying obstruction of the upper airway. METHOD: The relevant literature up to 2008 on the surgical treatment of OSA was selectively reviewed. RESULTS: Five types of surgical treatment for OSA are available, each for its own indications: optimization of the nasal airway to support nasal ventilation therapy, (adeno-)tonsillectomy as first-line treatment for OSA in children, minimally invasive surgery for simple snoring and mild OSA, invasive surgery as first- and second-line treatment for mild OSA, and invasive multilevel surgery as second-line treatment of moderate to severe OSA that remains refractory to ventilation therapy. CONCLUSION: Surgical treatment for OSA is appropriate for specific indications as a complement to the established conservative treatment methods.
BACKGROUND: Obstructive sleep apnea (OSA) is a very common disorder among adults: the prevalence of mild OSA is 20%, and that of moderate or severe OSA is 6% to 7%. Simple snoring is even more common. Conservative treatments such as nocturnal ventilation therapy and oral appliances are successful as long as the patient actually uses them, but they do not eliminate the underlying obstruction of the upper airway. METHOD: The relevant literature up to 2008 on the surgical treatment of OSA was selectively reviewed. RESULTS: Five types of surgical treatment for OSA are available, each for its own indications: optimization of the nasal airway to support nasal ventilation therapy, (adeno-)tonsillectomy as first-line treatment for OSA in children, minimally invasive surgery for simple snoring and mild OSA, invasive surgery as first- and second-line treatment for mild OSA, and invasive multilevel surgery as second-line treatment of moderate to severe OSA that remains refractory to ventilation therapy. CONCLUSION: Surgical treatment for OSA is appropriate for specific indications as a complement to the established conservative treatment methods.
Authors: Sarah Ulrike Leitzbach; Robert Bodlaj; Joachim Theodor Maurer; Karl Hörmann; Boris Alexander Stuck Journal: Eur Arch Otorhinolaryngol Date: 2014-01-08 Impact factor: 2.503
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