When to consider surgery
For adults with obstructive sleep apnea, CPAP is the most studied long-term treatment. Surgery is appropriate when anatomic obstruction is identifiable and when CPAP has been unsuitable, intolerable, or insufficient. The decision is made jointly between sleep medicine, ENT, and — when relevant — plastic surgery.
Common indications
- Severe nasal obstruction (deviated septum, hypertrophic turbinates) that compromises CPAP fit
- Significantly enlarged tonsils or adenoids (especially in pediatric patients)
- Redundant palatal tissue with a clearly defined obstruction site
- CPAP intolerance after a documented adherence-coaching attempt
- Skeletal craniofacial anomaly amenable to advancement surgery
Surgical procedures we coordinate
We do not perform surgery in-house; we coordinate with ENT and oral-maxillofacial surgical partners. Our role is to evaluate, indicate, and follow up — and to verify outcomes against a post-operative polysomnogram.
Septoplasty & turbinate reduction
Restores nasal patency. Often a prerequisite for successful CPAP use; rarely curative for sleep apnea on its own.
Tonsillectomy & adenoidectomy
First-line for pediatric obstructive sleep apnea. Adult cases with grossly enlarged tonsils can also benefit.
UPPP (uvulopalatopharyngoplasty)
Removes redundant palatal tissue. Long-term cure rate is modest for sleep apnea; a careful selection is essential.
Palatal stiffening / radiofrequency
Less invasive options for snoring without significant apnea. We are conservative about claims of efficacy.
Maxillomandibular advancement (MMA)
For severe skeletal cases. High efficacy in selected patients but a major surgery; see our jaw surgery page.
Pre- and post-operative workup
- Baseline polysomnogram with severity staging
- Drug-induced sleep endoscopy (DISE) when obstruction site is uncertain
- Cephalometric and imaging review for skeletal candidates
- Post-operative polysomnogram at three to six months to verify outcome
- Long-term review annually — recurrence is common and worth monitoring
What surgery cannot do
Surgery does not modify weight, alcohol use, or supine sleep — common contributors to obstructive sleep apnea. We will not recommend an operation as a substitute for the lifestyle and behavioral work that often accompanies long-term improvement.
For specific anatomic patterns surgery can be transformative. For most adult cases, however, the long-term cure rate is lower than CPAP's effectiveness. Surgery is one tool — not a default. — Dr. Han Jin-Kyu