ABSTRACT

There are potentially different phases of upper airway reconstruction. The initial phase of surgery directs treatment to the specific areas of obstruction. Persons with isolated obstruction at the level of the soft palate receive a palatal surgical procedure and patients with obstruction at the level of the base of tongue undergo a procedure designed to improve this region. If the patient has both palatal and base of tongue obstruction, they receive procedures directed at both sites, either simultaneously or staged. The determination of the timing of surgery is dictated by the following: the patient’s ability to use nasal CPAP to protect the upper airway from collapse postoperatively, the severity of SDB, the safety and stability of the upper airway, and the number and sites of upper airway reconstructive procedures. When nasal obstruction is identified, it is usually addressed with a staged nasal procedure before or after the palate and/or hypopharyngeal areas are treated. If the patient does not have severe SDB, nasal surgery may be elected to proceed along with other upper airway reconstructive procedures.