Meet Our Sleep Apnea Surgeons
Functional Pharyngoplasty (Uvulopalatopharyngoplasty or UPPP)
The back of the throat, known as the soft palate, can collapse. This makes it difficult for air to move freely through the throat.
Functional pharyngoplasty (also known as Uvulopalatopharyngoplasty, UPPP or UP3) is a surgical procedure that removes or remodels tissue at the back of the throat, including:
- The uvula: The small projection that hangs from the back of the throat
- Tonsils: Two lymph nodes in the back of the throat
- Adenoids: Patches of tissue in the back of the nasal cavity
- Part of the roof of the mouth
UPPP surgery is ideal for people who are not significantly overweight. Although the recovery process can be painful, most people recover in three to four weeks and notice an improvement after two months.
Transpalatal Advancement Pharyngoplasty
The back of the throat, known as the soft palate, can collapse. This makes it difficult for air to move freely through the throat.
Penn Medicine is one of the few health systems in the country offering transpalatal advancement pharyngoplasty for soft palate collapse. In this procedure, surgeons remove the back part of the hard palate, which is the bony plate on the roof of your mouth. By shortening the hard palate, the soft palate is shifted forward, and the airway is opened.
Recovery from transpalatal advancement pharyngoplasty typically takes two weeks, and most people notice an improvement after a month.
TransOral Robotic Surgery for Obstructive Sleep Apnea (OSA TORS)
In TransOral Robotic Surgery (TORS), surgeons use a state-of-the-art da Vinci® Surgical System to widen the airway by removing excess tissue from areas of the throat that are difficult to reach with traditional surgery.
This minimally-invasive procedure eliminates the need for:
- External incisions
- Pharyngotomy: A surgical incision in the cavity behind the nose and mouth
- Tracheotomy: A surgical incision in the windpipe
After TORS, most people recover in the hospital in about three days, fully recover after three weeks, and notice improvements after two months.
Hypoglossal Nerve Stimulation
For some people with sleep apnea, the tongue is responsible for obstructing the airway. You may also have several levels of blockage at the same time, such as tongue and soft palate collapse.
Hypoglossal nerve stimulation is an effective treatment in this case. The device is a small, fully-implanted system that restores muscle tone to the muscles in your upper airway.
The device monitors breathing patterns while you sleep. When obstructions occur, it delivers mild, rhythmic stimulation to the hypoglossal nerve, which controls the movement of your tongue and other key airway muscles. Stimulating these muscles allows the airway to remain open during sleep.
The system has three components that are implanted during a minimally-invasive outpatient procedure:
- A neurostimulator
- A pressure sensing lead
- A stimulation lead
Most people recover from the implantation procedure after a few days and don’t notice the device. The system is controlled by a handheld remote that allows you to turn it on and off or to program it for a certain length of time. It can also be monitored and adjusted remotely by your physician.
Hypoglossal nerve stimulation is ideal for people 22 years and older who are not significantly overweight.
Tongue Reduction
People with excess tissue at the back of the tongue often have sleep apnea. This is especially common among people with Down syndrome or macroglossia, which is an unusually large tongue.
Tongue reduction is a surgical procedure that reduces the overall size of the base of the tongue. It’s performed at Penn by Erica Thaler, MD, using TransOral Robotic Surgery (TORS).
Partial Epiglottidectomy
The epiglottis is a small piece of tissue at the base of the tongue that covers the windpipe, keeping food from going into the windpipe during swallowing. A floppy epiglottis can block the airway, making breathing more difficult.
For some, a mouth guard or cervical pillow is an effective solution. Others may need a surgical procedure to find relief.
A partial epiglottidectomy removes about one third of the epiglottis. This resolves the problem by both shortening and stiffening the cartilage in the epiglottis.
Recovery from a partial epiglottidectomy typically takes one to two weeks, and most people notice an improvement after about two weeks.