옵션, 효능, 그리고 비용 : 코골이에 대한 수술

에 포스팅됨 16 November 2018

While most people snore occasionally, some people have a long-term problem with frequent snoring. When you sleep, the tissues in your throat relax. Sometimes these tissues vibrate and create a harsh or hoarse sound.

Risk factors for snoring include:

  • excess bodyweight
  • being male
  • having a narrow airway
  • drinking alcohol
  • nasal problems
  • family history of snoring or obstructive sleep apnea

In most cases, snoring is harmless. But it can greatly disrupt you and your partner’s sleep. Snoring can also be a sign of a serious health condition called sleep apnea. This condition causes you to start and stop breathing repeatedly during sleep.

The most serious type of sleep apnea is called obstructive sleep apnea. This happens because of overrelaxation of the muscles in the back of your throat. The relaxed tissue blocks your airway while you sleep, making it smaller, so less air can be breathed in.

The blockage can be worsened by physical deformities in the mouth, throat, and nasal passages, as well as nerve problems. Enlargement of the tongue is another major cause of snoring and sleep apnea because it falls back into your throat and blocks your airway.

Most doctors recommend using a device or mouthpiece to keep your airway open while you sleep. But sometimes surgery is recommended for severe cases of obstructive sleep apnea or when other therapies aren’t effective.

In many cases, surgery can be successful in reducing snoring and treating obstructive sleep apnea. But in some cases, snoring returns over time. Your doctor will examine you to help determine which treatment is best for you.

Here are some surgeries your doctor may recommend:

Pillar procedure (palatal implant)

The pillar procedure, also called a palatal implant, is a minor surgery used to treat snoring and less severe cases of sleep apnea. It involves surgically implanting small polyester (plastic) rods into the soft upper palate of your mouth.

Each of these implants is about 18 millimeters long and 1.5 millimeters in diameter. As the tissue around these implants heals, the palate stiffens. This helps keep the tissue more rigid and less likely to vibrate and cause snoring.

Uvulopalatopharyngoplasty (UPPP)

UPPP is a surgical procedure done under local anesthesia that involves removing some the soft tissues in the back and top of the throat. This includes the uvula, which hangs at the throat’s opening, as well as some of the throat walls and palate.

This makes breathing easier by keeping the airway more open. While rare, this surgery can cause long-term side effects like problems swallowing, voice changes, or the permanent feeling of something in your throat.

When tissue from the back of the throat is removed using radiofrequency (RF) energy, it’s called radiofrequency ablation. When a laser is used, it’s called laser-assisted uvulopalatoplasty. These procedures can help snoring but aren’t used to treat obstructive sleep apnea.

Maxillomandibular advancement (MMA)

MMA is an extensive surgical procedure that moves the upper (maxilla) and lower (mandibular) jaws forward to open your airway. The extra openness of the airways can reduce the chance of obstruction and make snoring less likely.

Many people who receive this surgical treatment for sleep apnea have a facial deformity that affects their breathing.

Hypoglossal nerve stimulation

Stimulating the nerve that controls the muscles in the upper airway can help keep airways open and reduce snoring. A surgically implanted device can stimulate this nerve, which is called the hypoglossal nerve. It’s activated during sleep and can sense when the person wearing it is not breathing normally.

Septoplasty and turbinate reduction

Sometimes a physical deformity in your nose may contribute to your snoring or obstructive sleep apnea. In these cases, a doctor may recommend septoplasty or turbinate reduction surgery.

A septoplasty involves straightening the tissues and bones in the center of your nose. A turbinate reduction involves decreasing the size of tissue inside your nose that helps moisten and warm the air you breathe.

Both of these surgeries are often done at the same time. They can help open the airways in the nose, making breathing easier and snoring less likely.

Genioglossus advancement

Genioglossus advancement involves taking the tongue muscle that attaches to the lower jaw and pulling it forward. This makes the tongue firmer and less likely to relax during sleep.

To do this, a surgeon will cut a small piece of bone in the lower jaw where the tongue attaches, and then pull that bone forward. A small screw or plate attaches the piece of bone to the lower jaw to hold the bone in place.

Hyoid suspension

In a hyoid suspension surgery, a surgeon moves the base of the tongue and elastic throat tissue called the epiglottis forward. This helps open the breathing passage more deeply into the throat.

During this surgery, a surgeon cuts into the upper throat and detaches several tendons and some muscle. Once the hyoid bone is moved forward, a surgeon attaches it into place. Because this surgery does not impact the vocal cords, your voice should remain unchanged after surgery.

Midline glossectomy and lingualplasty

Midline glossectomy surgery is used to reduce the size of the tongue and increase the size of your airway. One common midline glossectomy procedure involves removing parts of the middle and back of the tongue. Sometimes, a surgeon will also trim the tonsils and partially remove the epiglottis.

Side effects differ depending on which type of snoring surgery you receive. However, some common side effects of these surgeries overlap, including:

  • pain and soreness
  • infection
  • physical discomfort, such as the feeling of having something in your throat or on top of your mouth
  • sore throat

While most side effects last only a few weeks after surgery, some can be more long-lasting. This may include:

  • dryness in your nose, mouth, and throat
  • snoring that continues
  • long-lasting physical discomfort
  • trouble breathing
  • change in voice

If you develop a fever after surgery or experience severe pain, call your doctor right away. These are signs of a possible infection.

Some snoring surgeries may be covered by your insurance. Surgery is usually covered when your snoring is caused by a diagnosable medical condition, like obstructive sleep apnea.

With insurance, snoring surgery may cost several hundred to several thousand dollars. Without insurance, it may cost up to $10,000.

Surgery for snoring is often seen as a last resort when a person does not respond to noninvasive treatments like mouthpieces or oral devices. There are many different options for snoring surgery, and each come with their own side effects and risks. Talk to a doctor to see which type of surgery is best for you.

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