Surgical therapy of sleep disordered breathing

Before the invention of CPAP therapy, the only effective surgical treatment for obstructive sleep apnea syndrome was tracheotomy. Now, surgical approa ches mainly focus on two anatomical sites. Each procedure influences either the retropalatal or retrolingual portion of the pharynx. They might be app lied individually,synchronously with other procedures, or sequentially with other therapeutic devices. Common methods of velar surgery include uvulopa latopharyngoplasty (UPPP), Laser-assisted uvuloplasty (LAUP), radiofrequenc y or uvula-flap. These techniques are indicated mainly in patients with mil d OSAS. Other procedures focus on the posterior airway space (PAS), includi ng operations that reduce the volume of the tongue or base of tongue. In se lected patients, an enlargement of the retrolingual airway is gained by ost eosynthetic techniques. Improvement of the nasal airway passage is gained b y performing a septoplasty and/or conchotomy. In this paper,the different m ethods and their indications for surgical therapy will be explained and the results are summarized.