Airway surgery represents an important part of contemporary treatment paradigms in adult obstructive sleep apnoea
Surgery in adult obstructive sleep apnoea (OSA) is an option used when continuous positive airway pressure (CPAP) therapy, the gold standard treatment, fails. CPAP failure usually occurs because of poor adherence or significant complications from CPAP or related devices such as a mandibular advancement splint. The best available evidence indicates that appropriate surgery can improve the quality of life and associated risk of comorbid conditions for carefully selected patients.
- 1. Elshaug AG, Moss JR, Southcott AM, Hiller JE. An analysis of the evidence-practice continuum: is surgery for obstructive sleep apnoea contraindicated? J Eval Clin Pract 2007; 13: 3-9.
- 2. Elshaug AG, Watt AM, Mundy L, Willis CD. Over 150 potentially low-value health care practices: an Australian study. Med J Aust 2012; 197: 556-560. <MJA full text>
- 3. Elshaug AG. Over 150 potentially low-value health care practices: an Australian study [letter]. Med J Aust 2013; 198: 85. <MJA full text>
- 4. Caples SM, Rowley JA, Prinsell JR, et al. Surgical modification of the upper airway for obstructive sleep apnea in adults: a systematic review and meta-analysis. Sleep 2010; 33: 1396-1407.
- 5. National Health and Medical Research Council. How to use the evidence: assessment and application of scientific evidence. Canberra: NHMRC, 2000. http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/cp69.pdf (accessed Aug 2013).
- 6. Woodson BT, Steward DL, Weaver EM, Javaheri S. A randomized trial of temperature-controlled radiofrequency, continuous positive airway pressure, and placebo for obstructive sleep apnea syndrome. Otolaryngol Head Neck Surg 2003; 128: 848-861.
- 7. Robinson S, Chia M, Carney AS, et al. Upper airway reconstructive surgery long-term quality-of-life outcomes compared with CPAP for adult obstructive sleep apnea. Otolaryngol Head Neck Surg 2009; 141: 257-263.
- 8. Browaldh N, Nerfeldt P, Lysdahl M, et al. SKUP3 randomised controlled trial: polysomnographic results after uvulopalatopharyngoplasty in selected patients with obstructive sleep apnoea. Thorax 2013; 68: 846-853.
- 9. Peker Y, Hedner J, Norum J, et al. Increased incidence of cardiovascular disease in middle-aged men with obstructive sleep apnea: a 7-year follow-up. Am J Resp Crit Care Med 2002; 166: 159-165.
- 10. Marti S, Sampol G, Muñoz X, et al. Mortality in severe sleep apnoea/hypopnoea syndrome patients: impact of treatment. Eur Respir J 2002; 20: 1511-1518.
- 11. Weaver EM, Maynard C, Yueh B. Survival of veterans with sleep apnea: continuous positive airway pressure versus surgery. Otolaryngol Head Neck Surg 2004; 130: 659-665.
- 12. MacKay SG, Carney AS, Woods C, et al. Modified uvulopalatopharyngoplasty and coblation channelling of the tongue for obstructive sleep apnea: a multi-centre Australian trial. J Clin Sleep Med 2013; 9: 117-124.
- 13. Weaver EM. Judging sleep apnea surgery. Sleep Med Rev 2010; 14: 283-285.
- 14. Marshall NS, Wong KK, Liu PY, et al. Sleep apnea as an independent risk factor for all-cause mortality: the Busselton health study. Sleep 2008; 31: 1079-1085.
- 15. Kezirian EJ, Weaver EM, Yueh B, et al. Risk factors for serious complications after uvulopalatopharyngoplasty. Arch Otolaryngol Head Neck Surg 2006; 132: 1091-1098.
- 16. Pang KP, Rotenberg BW, Woodson BT. Advanced surgical techniques in snoring and obstructive sleep apnea. San Diego: Plural Publishing, 2013.
- 17. Berry RB, Kryger MH, Massie CA. A novel nasal expiratory positive airway pressure (EPAP) device for the treatment of obstructive sleep apnea: a randomized controlled trial. Sleep 2011; 34: 479-485.
Publication of your online response is subject to the Medical Journal of Australia's editorial discretion. You will be notified by email within five working days should your response be accepted.