Tongue advancement enlarges airway for better breathing

For people with obstructive sleep apnea (OSA) who cannot use, or choose not to use, a continuous positive airway pressure (CPAP) machine, tongue advancement surgery and tongue base reduction may be an option. The goal of the procedure (also called genioglossus advancement) is to make room for the tongue to relax during sleep while enlarging your airway so you can breathe better.

How tongue advancement surgery works and what to expect

The surgery is done while you’re under general anesthesia (you’ll be asleep for the procedure). By way of an incision (cut) inside your lower lip, your surgeon makes a cut in the jawbone just beneath your bottom front teeth where your genioglossus (the largest muscle in the tongue) is attached. A segment of that part of the jawbone is moved forward along with the attached tongue muscle. The bone is then held in place with a titanium screw that keeps the tongue from moving back again.

A less invasive tongue advancement surgery is done with a special plastic cord that loops under the front of the tongue and fastens to a screw in the lower jaw bone. Again, the goal is to keep the tongue from falling back into the airway when you’re sleeping.

Tongue advancement surgery is not for everyone. In most cases of OSA, your doctor will suggest a variety of non-surgical treatment methods. If your sleep apnea continues to affect your quality of life in spite of other treatment approaches, surgery might be the right approach for you.

Tongue reduction surgery may also help severe sleep apnea

In some cases, an enlarged tongue may be contributing to nighttime breathing problems. Coblation, use of radiofrequency energy and saline (salty water) may be used to shrink and tighten muscle and tissue near the back of the tongue. This surgery is also performed while the patient is under anesthesia. The surgery results in a permanent reduction in tongue size and does not affect the surrounding areas.

Tongue reduction may be performed in combination with other surgeries to improve sleep apnea and breathing problems. But like other surgical approaches, tongue reduction is considered only after other less invasive treatment options have been explored and tried.

To schedule an appointment with a specialist at Main Line Health, call 1.866.CALL.MLH (1.866.225.5654) or use our secure online appointment request form.