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The first involves surgery of the soft tissue (tonsillectomy, uvulopalatopharyngoplasty) and the second involves skeletal surgeries (maxillomandibular advancement). First, Phase 1 or soft tissue surgery is performed and after re-testing with a new sleep study, if there is residual sleep apnea, then Phase 2 surgery would consist of jaw surgery.
Sleep disordered breathing is a spectrum of disorders that includes snoring, upper airway resistance syndrome, and obstructive sleep apnea. These surgeries are performed by surgeons trained in otolaryngology, oral maxillofacial surgery, and craniofacial surgery.
The most common complications of pharyngeal flap surgery include airway obstruction and obstructive sleep apnea (Pena, 2000). Snoring has also been noted as a possible negative outcome of the surgery (Sloan, 2000). As a result of flap surgery, the airway is compromised in several ways.
For habitual snoring, the soft palate and the uvula are targeted; For obstructive sleep apnea, the base of the tongue and other airway structures are targeted; Note: the actual areas targeted depends on each individual's specific anatomy, so the above are just general associations.
The score is assessed by asking the patient, in a sitting posture, to open their mouth and to protrude the tongue as much as possible. [1] The anatomy of the oral cavity is visualized; specifically, the assessor notes whether the base of the uvula, faucial pillars (the arches in front of and behind the tonsils) and soft palate are visible.
A pharyngeal flap surgery unites the posterior pharyngeal wall and the soft palate to definitively occlude the midsagittal aspect of the palatopharyngeal port while bilaterally maintaining patencies between the nasopharynx and oropharynx to facilitate nasal respiration and resonance during the production of nasal phonemes.