Obstructive Sleep Apnoea (OSA) surgery is performed to treat moderate to severe cases of OSA when non-surgical treatments like CPAP (Continuous Positive Airway Pressure) or oral appliances are ineffective or not tolerated. The goal of surgery is to remove, reduce, or reposition tissues that block the upper airway during sleep, improving airflow and reducing apnoeic episodes.

Common Surgical Procedures for OSA:

1. Uvulopalatopharyngoplasty (UPPP):
   Removes excess tissue from the soft palate, uvula, and pharynx to widen the airway.

2. Genioglossus Advancement (GA):
   Moves the tongue muscle attachment forward to prevent airway collapse.

3. Maxillomandibular Advancement (MMA):
   Surgically repositions the upper and lower jaws forward to enlarge the airway. It is one of the most effective surgeries for severe OSA.

4. Tonsillectomy/Adenoidectomy:
   Removes enlarged tonsils or adenoids, common in children and some adults with OSA.

5. Nasal surgery (e.g., septoplasty, turbinate reduction):
   Improves nasal airflow by correcting structural issues.

6. Hypoglossal nerve stimulation (Inspire therapy):
   A surgically implanted device stimulates the tongue nerve to keep the airway open during sleep.

Indications for Surgery:

• Failure or intolerance of CPAP

• Anatomical airway obstruction

• Severe OSA with health complications

• Patient preference for a permanent solution

Benefits:

• Reduced or eliminated apnoeic episodes

• Improved sleep quality

• Decreased daytime fatigue

• Lower risk of cardiovascular issues associated with untreated OSA

Risks:

• Bleeding, infection, pain

• Swelling or difficulty swallowing

• Voice changes (rare)

• Need for additional surgeries if symptoms persist

Multidisciplinary Approach:

Evaluation and treatment planning often involve sleep specialists, ENT surgeons, oral and maxillofacial surgeons, and sometimes pulmonologists.

In summary, OSA surgery aims to open the airway and improve breathing during sleep. It is tailored to the patient’s anatomy and severity of the condition and may significantly improve quality of life when conservative treatments fail.