Snoring can be more than an annoying nighttime sound. In some people, it is linked to restricted airflow or obstructive sleep apnoea, a condition where the upper airway repeatedly narrows or collapses during sleep.
When structural problems within the nose or throat contribute to these issues, ENT surgery for snoring and sleep apnoea may be considered. Modern treatment focuses on identifying the exact location of airway obstruction and targeting the areas that are contributing to the problem.
What Is ENT Sleep Surgery?
ENT surgery for sleep-related breathing disorders aims to improve airflow through the nose and throat. The type of procedure depends on the patient’s anatomy and the location of the obstruction.
The Snoring & Sleep Clinic explains that obstruction can involve several areas, including the nose, soft palate, tonsils, and tongue base.
This is why treatment isn’t necessarily the same for every patient.
When Might Surgery Be Considered?
Surgery isn’t automatically the first treatment for everyone who snores. It may become an option when symptoms continue despite non-surgical approaches or when a clear anatomical obstruction is identified.
Common problems that may contribute to restricted airflow include:
- Deviated nasal septum
- Enlarged turbinates
- Chronic nasal congestion
- Nasal polyps
- Enlarged tonsils
- An elongated soft palate
- Palatal tissue vibration
- Tongue-base crowding
In some patients, obstruction occurs at more than one level of the airway.
Why Is a Detailed Assessment Important?
Before considering surgery, understanding exactly where the airway is narrowing is essential.
A specialist assessment can include an examination of the nose, throat, tonsils, palate, tongue base, and overall airway anatomy. A sleep study may also be used to confirm the presence and severity of sleep apnoea.
Another important investigation is Drug-Induced Sleep Endoscopy (DISE). During DISE, the airway is observed under sleep-like conditions to identify how and where it collapses. The results can help guide decisions about which surgical areas are most likely to benefit.
Common Types of ENT Surgery
Nasal Surgery
Nasal obstruction can make breathing through the nose difficult and may encourage mouth breathing during sleep.
Depending on the cause, procedures can include septoplasty to correct a deviated septum, turbinate reduction to improve nasal airflow, or sinus surgery for selected patients with conditions such as nasal polyps or sinus disease.
Improving nasal airflow may also help some people tolerate CPAP more comfortably.
Tonsil and Throat Surgery
Enlarged tonsils can narrow the airway and contribute to snoring or obstructive sleep apnoea. In appropriate cases, tonsillectomy may be recommended.
Other procedures can address the soft palate, where excess tissue or vibration contributes to airway obstruction.
Palatal Procedures
Palatal surgery can involve several techniques. Depending on the individual’s anatomy, options may include radiofrequency treatment, UPPP, expansion sphincter pharyngoplasty, or barbed suture pharyngoplasty.
The purpose is to reduce problematic vibration or improve the space available behind the palate.
Tongue-Base Procedures
For some patients, the tongue base contributes to airway collapse during sleep.
Specialist assessment can determine whether procedures designed to reduce tissue bulk, improve tongue position, or create additional airway space could be appropriate. DISE findings can be particularly useful when making this decision.
What Is Multilevel Sleep Surgery?
Some people have airway obstruction in more than one location. Treating only one area may therefore not address the complete problem.
Multilevel sleep surgery involves treating two or more areas when investigations show that each is contributing to airway obstruction. The Snoring & Sleep Clinic describes its approach as using DISE to guide targeted multilevel surgery and avoid unnecessary procedures.
This personalised approach can be particularly important in obstructive sleep apnoea, where airway collapse may involve several structures.
Can Surgery Help With CPAP Problems?
CPAP is an established treatment for obstructive sleep apnoea, but some people struggle to use it comfortably.
Nasal obstruction or throat anatomy can sometimes make CPAP more difficult to tolerate. In selected patients, ENT surgery may improve nasal airflow or address another anatomical obstruction, potentially making CPAP easier to use.
Surgery should therefore not necessarily be viewed as an alternative to every other treatment. In some cases, it can form part of a wider treatment plan.
What Is Recovery Like?
Recovery depends heavily on the type and extent of surgery.
The Snoring & Sleep Clinic notes that some nasal procedures may allow a return to light activities within days, while throat procedures can require a longer recovery period. Follow-up is important for monitoring healing and assessing changes in symptoms.
Sleep outcomes may also be assessed through repeat sleep testing, particularly when surgery has been performed to treat obstructive sleep apnoea.
Choosing an ENT Sleep Specialist
Because snoring and sleep apnoea can have multiple causes, choosing a specialist who takes a comprehensive approach can be valuable.
Mr Ryan Cheong, Consultant ENT and Sleep Surgeon at the Snoring & Sleep Clinic, focuses on airway and sleep-related ENT procedures. The clinic highlights his experience with DISE-guided treatment, nasal and throat surgery, multilevel airway surgery, and management of CPAP intolerance.
The clinic provides consultations at Welbeck in Marylebone and Cleveland Clinic London’s outpatient centre.
Final Thoughts
ENT surgery can play an important role when anatomical problems contribute to snoring or obstructive sleep apnoea. From nasal surgery and tonsillectomy to palatal and tongue-base procedures, treatment can be tailored to the specific location and pattern of airway obstruction.
The key is proper diagnosis. A detailed ENT examination, sleep study, and—when appropriate DISE can help establish whether surgery is suitable and which areas should be targeted.
For people considering ENT surgery in London for snoring or sleep apnoea, a specialist consultation can provide a clearer understanding of the underlying problem and the treatment options available.
