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Contemporary Reviews in Sleep Medicine |

Surgical Management of OSA in AdultsSurgical Management of Adult OSA

David F. Smith, MD, PhD; Aliza P. Cohen, MA; Stacey L. Ishman, MD, MPH
Author and Funding Information

From the Division of Pediatric Otolaryngology–Head and Neck Surgery (Drs Smith and Ishman and Ms Cohen) and Division of Pulmonary Medicine (Dr Ishman), Cincinnati Children’s Hospital Medical Center, Cincinnati, OH; and Department of Otolaryngology–Head and Neck Surgery (Dr Ishman), University of Cincinnati College of Medicine, Cincinnati, OH.

CORRESPONDENCE TO: Stacey L. Ishman, MD, MPH, Division of Pediatric Otolaryngology–Head and Neck Surgery and Division of Pediatric Pulmonary Medicine, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, MLC 2018, Cincinnati, OH 45229; e-mail: stacey.ishman@cchmc.org


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;147(6):1681-1690. doi:10.1378/chest.14-2078
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OSA is a common, often chronic, condition requiring long-term therapy. Given the prevalence of OSA, as well as its significant health-related sequelae, a range of medical and surgical treatments have been developed and used with varying success depending on individual anatomy and patient compliance. Although CPAP is the primary treatment, many patients cannot tolerate this treatment and require alternative therapies. In this clinical scenario, surgery is often warranted and useful. Surgical management is aimed at addressing obstruction in the nasal, retropalatal, and retroglossal/hypopharyngeal regions, and many patients have multiple levels of obstruction. This review presents a comprehensive overview of research findings on a wide spectrum of surgical approaches currently used by sleep clinicians when other therapeutic modalities fail to achieve positive outcomes.

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