Surgery for Sleep Disordered Breathing

Book excerpt: Nasal continuous positive airway pressure ventilation is the gold standard in the treatment of obstructive sleep apnea. Long-term compliance rates are about 60%. Therefore, several alternative treatment options are of special interest. Beside conservative therapies, various surgical concepts exist. The field of surgery for sleep disordered breathing has rapidly grown with new instrumentation and surgical techniques in the last 10 years. Surgeons in these fields have to attend scientific meetings, participate in workshops, and read the literature to stay up to date. In our sleep laboratories we conduct 30 polysomnographies each night. Each year, we perform almost 1,000 surgical procedures for sleep disordered breathing apart from numerous other conservative and apparative treatment modalities. Referring to our expe- ence and the present literature, we tried to give new information on surgical techniques in this second edition. The chapters are grouped in different anatomical fields of interest. We wanted to give general advice and specific new hints for the surgery of sleep disordered breathing so that the reader learns basic techniques followed by more advanced surgery. In addition to the illustrated surgical descriptions, the chapters contain informations about indications and contraindications of each surgical procedure and the postoperative care. Special interest has been dedicated to evidence-based medicine. So in each chapter, there is a table of references summarizing the effectiveness of the procedure and EBM grade.