[Surgical therapy options in obstructive sleep apnoe and snoring]

Area of Science:

• Otolaryngology
• Sleep Medicine
• Surgical Therapy

Background:

• Obstructive sleep apnea (OSA) affects 20% of adults with mild cases and 6-7% with moderate to severe cases.
• Continuous positive airway pressure (CPAP) is the gold standard for moderate to severe OSA but suffers from poor patient adherence.
• Surgical interventions provide an alternative with 100% therapy adherence.

Purpose of the Study:

• To review surgical treatment options for primary snoring and mild to moderate obstructive sleep apnea (OSA).
• To highlight the importance of preoperative diagnostics for successful surgical outcomes.
• To compare surgical success criteria with CPAP therapy effectiveness.

Main Methods:

• Review of current literature on surgical treatments for OSA.
• Emphasis on preoperative diagnostics including ENT examination and sleep medicine history.
• Inclusion of drug-induced sleep endoscopy (DISE) for detailed collapse assessment.

Main Results:

• Surgical therapy offers complete adherence, contrasting with CPAP's adherence issues.
• Surgical success is defined by a reduction in apnea-hypopnea index (AHI) by half, to below 20/h.
• CPAP success is defined as AHI < 5/h, but adherence remains a critical factor.

Conclusions:

• Surgical therapy is a viable option for mild to moderate OSA, especially when CPAP adherence is poor.
• Thorough preoperative evaluation is essential for optimizing surgical success in OSA.
• In severe OSA, surgery is adjunctive to ventilation therapy or for CPAP-intolerant patients.