Obstructive Sleep Apnea (OSA) is a chronic illness with the risks of secondary cardio-vascular and neuro-cognitive morbidities. Continuous Positive Airways Pressure (CPAP) is the accepted first line treatment for OSA. Patients who fail treatment with CPAP and other conservative measures, should be considered for surgery after discussion in a multi-disciplinary clinic for sleep disordered breathing.
A structured approach to Surgery for OSA has been clearly defined and accepted by the American Academy of Sleep Medicine (1). The aim of surgery is to address the collapsibility of structures of the upper airway. The tongue base can contribute to OSA.
The following techniques which aim to reduce the volume of the tongue base are described:
1) External Submucosal Glossectomy
2) Percutaneous Submucosal Glossectomy
3) Intraoral Submucosal Endoscopic Assisted Linguaplasty (SMILE)
4) Intraoral Submucosal Midline Glossectomy
5) Intraoral Submucosal Linguaplasty