Role of surgery in adult obstructive sleep apnoea

A surgical approach to treatment of obstructive sleep apnoea (OSA) remains an area of intense debate, both within and without the surgical community itself. Continuous positive airway pressure (CPAP) therapy remains the gold standard for the treatment of OSA, however surgery may be indicated to facilitate CPAP and/or improve compliance in cases where CPAP is poorly tolerated. This article summarises the current range of surgical treatment options together with the evidence base for their intervention in otolaryngology, maxillofacial and bariatric surgery. The continued evolution of technology has brought new surgical techniques to the fore and it seems likely their utilisation together with a multi-level surgical approach to the airway will continue to influence forthcoming research in OSA. Patient selection and precise evaluation will remain crucial in ensuring that when surgery is indicated, the correct procedure or procedures are performed at the correct anatomical level.