Our experts have unmatched experience with performing tongue region procedures. Two-thirds of patients who have sleep apnea experience obstructed breathing in the tongue region, according to research. Until recently, it had not been possible to treat blockage of this type with surgery. Over the past 20 years, a number of procedures specific to treating this region have been developed. Studies show that combining these procedures with palate surgery improves results.
Blockage in the tongue region can be caused by different structures, including the tongue itself, the sides of the throat and the epiglottis (a structure that functions like a trap door covering the windpipe so that food and liquids do not enter the lungs).
The most common procedures to treat structural issues in the tongue region are:
Epiglottidectomy (Epiglottis Surgery)
An epiglottidectomy involves partial removal of the epiglottis. This is a structure in the throat that covers the windpipe so food does not enter the lungs. The procedure is performed through the open mouth without any skin incisions and may involve use of a laser or other method to remove a portion of the epiglottis.
In a genioglossus advancement procedure, the section where the genioglossus – the largest muscle of the tongue – attaches to the lower jaw is moved forward. This procedure creates more room for the tongue to relax during sleep without obstructing the throat. The surgery also enlarges and stabilizes the airway.
The hyoid bone (U-shaped bone in the neck located above the thyroid cartilage) is not firmly anchored, and it may collapse more easily during sleep, causing breathing obstruction. The hyoid suspension procedure secures the hyoid bone to the thyroid cartilage reducing airway obstruction.
In some patients, the lingual tonsils (tonsil tissue located on the back of the tongue) may be enlarged, which may contribute to obstruction of the airway during sleep. In a lingual tonsillectomy, the lingual tonsil is removed to enlarge the airway behind the tongue.
Midline glossectomy (using various techniques including submucosal lingualplasty) is performed in patients with large tongues wherein the size of the tongue contributes to obstruction in sleep apnea. This procedure involves removing portions of the middle and back of the tongue. For extensive procedures, the major blood vessels and nerves are identified via ultrasound prior to the procedure and are protected during the procedure.
Tongue radiofrequency is used to tighten and shrink tongue tissues by a controlled cauterization that creates scar tissue. The procedure makes the tongue less likely to fall backward and block breathing during sleep. It may be performed in two to four treatment sessions in an operating room or outpatient clinic without requiring general anesthesia or sedation.
This procedure is often performed in patients who have not obtained relief from other procedures for sleep apnea. In this procedure, the upper and lower jaws are moved forward enlarging the airway in both the palate and tongue regions. It may also be a first-line treatment for patients who have jaw abnormalities.