When is surgical care indicated for obstructive sleep apnea (OSA)?

Updated: Sep 15, 2020
  • Author: Himanshu Wickramasinghe, MD, MBBS; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

Surgical care for OSA patients should not be seen as a "last ditch" effort in treatment of OSA patients. Surgery may be initial therapy for patients with mild OSA (RDI < 20, lowest oxyhemoglobin saturation >90%) if medical therapy is refused or rejected and if the patients are medically stable enough to undergo the procedure. Surgery may be indicated if noninvasive medical therapy, nasal CPAP, or OA fails to effectively treat OSA or is rejected by the patient.

Surgery is also indicated in patients who have a specific underlying abnormality that is causing the OSA. Three of 200 adults with OSA have a specific space-occupying lesion that causes an UA obstruction. Although surgical correction of such an abnormality (ie, tonsillectomy) can potentially cure OSA, most adult patients do not have such correctible lesions.


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