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.
The treatment of sleep disordered breathing has been enriched by the development of various new and largely surgical techniques. The question of which treatment best suits each individual patient has become a highly sophisticated decision. Among others, the most important factors for selecting the most appropriate treatment modality are the cruelty of the disease, the pathology found within the upper airway, and the sites of obstruction. Therefore, the second edition of this book focuses on both the surgical treatment modalities and the current concepts for treatment decisions.
For each procedure, current data (including data for the entirety of 2007) were reanalyzed according to the principles of evidence-based medicine, and are presented in well-arranged tables. Indications, techniques, complications, and specific follow-up treatments in the realm of sleep medicine have been compiled in the form of a primer.
New chapters concerning radiofrequency-uvulopalatoplasty and combined soft palate procedures were added.
Both authors run prominent otolaryngological sleep laboratories, and perform approximately 1,500 surgical sleep medicine procedures per year. The complete surgical and sleep medicine expertise of the authors, as well as the experience of numerous international courses on sleep surgery, have been incorporated into this volume, making it an indispensable textbook for sleep medicine surgeons.
