If I have severe snoring, can I undergo surgery?

Clinically, there is an interesting phenomenon regarding the treatment of snoring. When a child has snoring, the first reaction of the parents is: "Can I avoid surgery?" However, when an adult has snoring, especially middle-aged people, a large proportion of patients will ask: "Will surgery cure it?"

If an adult is diagnosed with OSAHS, the treatment is different from that for children. The biggest difference is that surgery is not a permanent solution. Many children with OSAHS who need surgery have enlarged tonsils and adenoids, which are usually cured immediately after surgical resection. However, many cases of OSAHS in adults are caused by a combination of factors, with obesity being the most significant. Surgery for OSAHS in adults can often only solve one or two problems, so surgery is not effective for all adult OSAHS patients.

Common "OSAHS" surgeries mainly refer to uvulopalatopharyngoplasty (UPPP) or various modified UPPP surgeries. During the operation, the tonsils, part of the soft palate, part of the uvula tissue, and the loose palatoglossal arch and pharyngeal palate arch mucosa are generally removed. Finally, the pharyngeal palate arch mucosa is pulled forward and sutured to expand the oropharyngeal space and improve oropharyngeal ventilation. The whole process is like tidying up a messy stage. First, all the unnecessary debris on the stage is removed, and then the curtain is put away and tied with ropes to prevent the curtain from drooping, so that the stage space is larger.

However, this surgery has its limitations and is not suitable for all "OSAHS" patients, or it is not always effective.

For example, the effect is very good for patients with huge tonsils, or hypertrophy of the soft palate and pharyngeal palate arch soft tissue. This is easy to understand, just like the stage mentioned earlier, if there are a lot of debris on the stage, or the curtain is too large, once these extra things are cleared, the stage will immediately become much more spacious. However, for cases where the pharynx is congenitally narrow, or the tongue is enlarged due to obesity, and the soft tissue of the neck is compressed, this surgery is somewhat helpless. Just like a small theater, no matter how it is tidied and repaired, it can never reach the spaciousness of a large theater.

In addition to UPPP, there are some surgeries related to "OSAHS", each with its own characteristics and limitations. For example, for some patients with "OSAHS" caused by obstruction in the nasal cavity or nasopharynx, the corresponding nasal surgery can also be regarded as part of the treatment of "OSAHS". Some friends have nasal congestion due to severe nasal septum deviation accompanied by rhinitis, and then snoring at night. After septum correction and partial ablation of the inferior turbinate, the snoring symptoms will be significantly relieved, but this is not the case for most "OSAHS" patients. For another example, some patients have congenital micrognathia, which means that the mandible is shorter than that of ordinary people. This causes the tissues in the oropharynx to appear crowded and block the airway. Such patients can consider maxillofacial surgery such as mandibular advancement. Due to the many causes of "OSAHS" in adults and the various surgical methods, not all problems can be solved by one surgery.

Compared to the good results of snoring surgery for children, the effect of snoring surgery for adults often decreases over time. As children grow and develop, their pharyngeal cavity will gradually become larger. Even if the airway is temporarily blocked by enlarged tonsils and adenoids, it will generally not recur after surgery. Even if adults undergo snoring surgery such as UPPP, the short-term effect may be good, but in the long run, the effect of the surgery will gradually disappear due to the loosening of the pharyngeal mucosa or the recurrence of obesity as they age.

Therefore, adult patients with OSAHS should undergo detailed evaluation by an otolaryngologist and develop an individualized treatment plan based on their different causes. According to our clinical experience, only about one-third of patients are suitable for surgery, while two-thirds of patients should choose a comprehensive treatment plan.

Therefore, adults who snore should carefully decide whether to undergo surgery.