nasal and mandibular surgeries as treatment options for OSA
- surgical option for OSA is a phased approach
- phase 1 involves soft tissue surgery
- phase 2 involves bone surgery
phase 1
- phase 1 involves tonsillectomy, septoplasty, turbinate reduction, uvulopalatal flap, hyoid suspension, genioglossus advancement
- drug induced sedation/sleep endoscopy (DISE) is examination of pharyngeal wall in office to see if there is collapse during negative pressure maneuver
- Septoplasty, nasal valve reconstruction/stabilization, turbinate reduction aim at expanding nasal floor for OSA from nasal obstruction
- Distraction osteogenesis with maxillary expansion (DOME) is used for expanding both nasal and intraoral airway
- Uvulopalatopharyngoplasty is most common surgery for OSA
- Genioglossus advancement: tongue moves forward more
- Lingual tonsillectomy: tongue volume reduction
phase 2
- maxillomandibular advancement: osteotomies of maxilla and mandible and move them forward with counterclockwise rotation1
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