Surgical treatments for obstructive sleep apnea
| Treatment | Indications | Reduction in apnea-hypopnea index | Caveats | Possible predictors of success |
|---|---|---|---|---|
| Hypoglossal nerve stimulation100–102 | Moderate to severe obstructive sleep apnea not tolerating CPAP; BMI < 40 kg/m2; AHI 15–100 | 68% | Tongue weakness, infection, hematoma, pneumothorax | Anteroposterior collapse, female, lower BMI and AHI, higher arousal threshold |
| Uvulopalatopharyngoplasty99 | Excessive daytime sleepiness, AHI > 15 | 33%; with laser-assisted uvuloplasty, 18% | Velopharyngeal insufficiency, nasal regurgitation, foreign body sensation | Velopharyngeal/retropharyngeal airway collapse |
| Tongue reduction99 | Macroglossia | 34% (radiofrequency ablation) | Bleeding, tongue edema causing airway obstruction, wound infection | Large base of tongue, macroglossia |
| Maxillomandibular advancement99 | Failure of other options, especially CPAP; can be a primary option with jaw deformities | 87% | Change in appearance, dental or facial numbness | Craniofacial deformities with retruded mandible |
AHI = apnea-hypopnea index; BMI = body mass index; CPAP = continuous positive airway pressure therapy