Otolaryngology

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Sleep Apnea Treatment

Obstructive Sleep Apnea Diagnosis and Surgical Treatment

Obstructive sleep apnea is a common condition that involves breathing problems during sleep, as the throat muscles relax and block the airway. Patients with obstructive sleep apnea often experience loud snoring, daytime sleepiness, morning headaches, insomnia and waking up with a sore throat. This condition can affect anyone, but is most common in older adults.

Sleep Apnea Treatment | Thyroid Surgery | Parathyroid Surgery | Lafayette LA | Eunice LA Your doctor may be able to diagnose obstructive sleep apnea after an evaluation of your symptoms. Additional testing may be needed in some cases, which may include:

Nocturnal polysomnography
Oximetry
Portable cardiorespiratory testing

These tests are performed while the patient is asleep to help detect any abnormal behaviors that may lead to sleep apnea.

Once the condition has been diagnosed, there are several treatment options available to manage symptoms and allow patients to enjoy uninterrupted sleep. While there are some nonsurgical treatments available, many patients with sleep apnea need surgery to remove excess tissue from the nose or throat in order to unblock the airways and promote healthy breathing.

Surgery for obstructive sleep apnea may include:

Surgical removal of tissue - this is performed through uvulopalatopharyngoplasty, a procedure that removes tissue from the throat as well as the tonsils and adenoids

Thyroid/Parathyroid Surgery

Thyroid Surgery

Thyroid surgery is a common procedure used to treat several conditions of the thyroid, the butterfly-shaped gland located in the neck. Surgery can remove part or all of the thyroid gland, depending on the type and severity of the condition.

Thyroid surgery is often used to treat:

Hyperthyroidism
Hypothyroidism

Thyroid cancer
Thyroid nodules

It is used most often for thyroid cancer, and is seen as a last resort for other conditions. The procedure is performed through an incision in the neck, although minor procedures can sometimes be performed through endoscopy. After undergoing thyroid surgery, most people need thyroid hormone medication for the rest of their lives.

Parathyroid Surgery

The most common disease associated with the parathyroid glands is overproduction of parathyroid hormone (PTH), known as hyperparathyroidism. Although medication is available to treat hyperparathyroidism, surgery is most often recommended and is the only cure.

Surgical removal of one or more parathyroid glands is called a parathyroidectomy.

A small incision will be made in your neck to remove the gland. Your particular problem will determine how many of the parathyroid glands need to be removed. Some parathyroid tissue, however, must be left in place to help prevent hypoparathyroidism (decreased parathyroid activity).

In most cases of hyperparathyroidism, only one gland has to be removed and a less invasive procedure called minimally-invasive radio-guided parathyroid (MIRP) surgery can be performed. MIRP surgery requires a much smaller incision and quicker recovery period.

Tonsils & Adenoids

The tonsils are two masses of tissue found on either side of the back of the throat. The adenoids are located high in the throat behind the nose and roof of the mouth. Together they form part of the ring of glandular tissue at the back of the throat. The tonsils and adenoids assist the body in defense against infection by "sampling" entering bacteria and viruses and becoming infected themselves. They then help form antibodies to resist and fight future infections. However, the tonsils and adenoids often become susceptible to recurrent bacterial infections and can even trigger airway obstruction.

Common problems afflicting the tonsils and adenoids include:

chronic tonsillitis or persistent infection of the tonsils
peritonsillar abscess, a collection of pus behind the tonsils that can lead to life-threatening complications if left untreated.

Bacterial infections of the tonsils and adenoids can be treated with various antibiotics. Surgical removal is considered when conditions are resistant to medical therapy or frequently recur. "Frequent recurrence" is loosely defined as 6-7 episodes per year; 4-5 episodes per year for a two year period; or 3 episodes per year for a three year period.

Tympanoplasty and Mastoidectomy

Tympanoplasty

Tympanoplasty is reconstructive surgery for torn tympanic membranes (eardrums) or ossicles (middle ear bones). Eardrum tears may result from chronic infection or, less commonly, from trauma to the eardrum. Tympanoplasty can also help to restore hearing, treat certain types of deafness, and prevent middle ear infections.

Tympanoplasty can be performed through the ear canal or through an incision behind the ear. Tympanic membrane grafting may be required in which a graft is taken from tissue under the skin around the ear to reconstruct the eardrum. The procedure is performed on an outpatient basis under local or general anesthetic.

Mastoidectomy

A mastoidectomy is the surgical removal of an infected portion of the mastoid bone (the prominent bone behind the ear) when medical treatment is not effective. The need for this surgery is relatively rare today due to the use of antibiotics.

Mastoidectomy is performed to remove infected air cells within the mastoid bone caused by mastoiditis, ear infections, or cholesteatoma (an inflammatory disease of the middle ear). The air cells are open spaces containing air that are located throughout the mastoid bone. They are connected to a cavity in the upper part of the bone which is connected to the middle ear. Infections in the middle ear can therefore spread through the mastoid bone, making surgery necessary if antibiotics do not work. A mastoidectomy may also be performed to repair paralyzed facial nerves.

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