Sleep Apnea Surgery in Singapore

• Patients with moderate to severe obstructive sleep apnoea confirmed by sleep study
• Individuals who have not been able to tolerate CPAP therapy
• Those with identifiable anatomical abnormalities contributing to airway obstruction
• Patients with appropriate body mass index for surgical consideration
• Adults with realistic expectations about surgical outcomes and recovery
• Non-smokers or those willing to quit before surgery
• Individuals committed to post-operative care and lifestyle modifications

• Morbid obesity as primary cause of sleep apnoea
• Severe cardiovascular disease that may increase surgical risk
• Bleeding disorders or medications that cannot be discontinued
• Active respiratory infections or uncontrolled chronic lung disease
• Unrealistic expectations about outcomes without lifestyle changes
• Central sleep apnoea or mixed sleep apnoea with significant central component
• Severe craniofacial abnormalities requiring complex reconstruction

A comprehensive evaluation by an ENT surgeon with experience in sleep disorders is recommended to determine surgical candidacy. This assessment includes reviewing sleep study results, performing physical examination of the airway, and often conducting drug-induced sleep endoscopy to identify specific obstruction sites.

*Individual suitability varies based on anatomy, medical history, and other factors. Treatment outcomes and recovery timelines may vary.*

Before surgery, patients undergo comprehensive evaluation including updated sleep studies, drug-induced sleep endoscopy, and often CT or MRI imaging to assess airway anatomy. Blood tests, cardiac clearance, and anaesthesia assessment help ensure surgical safety. Patients must discontinue blood-thinning medications as directed and arrange for post-operative assistance at home. Smoking cessation at least four weeks before surgery may help improve healing outcomes. Pre-operative dental evaluation may be necessary for procedures involving the jaw or when dental splints are required.

On surgery day, patients receive general anaesthesia administered by an anaesthetist familiar with airway management in sleep apnoea patients. The surgical duration varies from approximately 45 minutes for simple UPPP to several hours for MMA procedures. Surgeons use specialised retractors to visualise the operative field whilst monitoring vital signs continuously. For palatal procedures, careful tissue removal and reconstruction aims to maintain structural integrity whilst creating airway opening. Jaw advancement procedures involve precise osteotomies (bone cuts) and rigid fixation with titanium plates. Throughout surgery, the team focuses on airway protection and optimal positioning for post-operative recovery.

Following surgery, patients recover in a monitored setting with continuous oxygen saturation monitoring. Pain management typically involves intravenous medications transitioning to oral analgesics. Swelling may peak around day 2-3, particularly for jaw surgeries, with ice application helping control inflammation. Most patients stay overnight for observation, though complex procedures may require longer hospitalisation. Clear liquid diet begins once swallowing safely resumes, with dietary progression based on procedure type. Discharge occurs when pain is controlled, vital signs stable, and patients can maintain adequate oral intake.

*Individual recovery experiences and timelines may vary.*

Temporary side effects may occur in patients but can resolve with proper care. Throat pain and difficulty swallowing may last for a period, which can be managed with painkillers and dietary changes. Temporary voice changes, particularly after palatal surgery, may normalise over time. Nasal regurgitation of liquids may occur initially but can improve as swelling subsides. Taste changes or numbness around the surgical site may gradually resolve over time. Small amounts of bleeding may be expected initially but should decrease daily. Ear discomfort from eustachian tube swelling may respond to decongestants and resolve spontaneously.

Serious complications may occur with any surgical procedure. Significant bleeding requiring intervention can occur. Velopharyngeal insufficiency, causing persistent nasal speech, may require additional treatment. Infection risk exists and appropriate antibiotic prophylaxis and wound care are important. Dental numbness or jaw joint problems can occur after MMA surgery but may improve with time. The procedure may not adequately resolve sleep apnoea and may necessitate additional procedures or return to CPAP therapy. Airway compromise immediately post-operatively requires vigilant monitoring and prompt management.

*Individual results and timelines may vary.*

Minimising risks involves careful patient selection, meticulous surgical technique, and comprehensive post-operative care. Choosing an experienced ENT surgeon familiar with sleep surgery is important.

*This treatment is administered as part of a comprehensive plan supervised by a healthcare professional.*

Maintain good indoor air quality by using air purifiers with HEPA filters, especially during haze periods. Keep humidity levels between 30-50% to discourage mould growth while preventing excessive dryness. Regular cleaning reduces dust mite exposure, a trigger in some homes.

Frequent handwashing may help prevent viral transmission that often precedes sinusitis. Avoid touching your face, particularly during flu season. Use tissue when sneezing or coughing, and dispose of it immediately. Consider wearing a mask during haze periods or when air quality is poor.

Stay well-hydrated to keep mucus thin and easily drainable. Avoid smoking and secondhand smoke exposure, which irritate sinus membranes. Manage allergies proactively with appropriate medications. Regular exercise may support immune function, potentially reducing infection susceptibility.

Annual flu vaccinations may reduce risk of viral infections leading to sinusitis. Treat allergic rhinitis consistently to help prevent sinus inflammation. Address dental problems promptly to prevent spread to maxillary sinuses. Consider preventive nasal sprays during high-risk periods as recommended by your ENT specialist.