UB Head and Neck Surgeon Provides Relief to Sleep Apnea Sufferers

UB Head and Neck Surgeon Provides Relief to Sleep Apnea Sufferers

Implant nerve stimulation surgery serves as alternative to CPAP machine.

Individuals diagnosed with obstructive sleep apnea often rely on a continuous positive airway pressure (CPAP) machine for relief. While these machines work effectively for many people, other people find them cumbersome and uncomfortable.

Fortunately, there is an alternative—a device that is surgically inserted to deliver gentle stimulation to nerves controlling muscles that open up the airway. In October, Michael Markiewicz, D.D.S., M.D., M.P.H., professor and Feagans Endowed Chair of the Department of Oral and Maxillofacial Surgery at the University at Buffalo School of Dental Medicine, successfully performed the first implant nerve surgery on two patients at Kaleida Health in Buffalo.

Each surgery lasted less than two hours and went smoothly, Dr. Markiewicz said. Both patients went home shortly after the procedure, were seen a week later for a wound check and had no issues. Infection is extremely rare, according to Dr. Markiewicz, who describes the surgery as having minimal risk.

The FDA-approved implant device, created by Inspire Medical Systems, stimulates the hypoglossal nerve and helps keep the airway open during sleep. The surgery includes two small incisions into the neck and chest and insertion of a stimulator coil and a respiratory monitor, respectively. After patients undergo the surgery, they work with their physicians to fine tune their therapy settings and learn how to use a remote to turn the therapy on and off.

Sleep apnea affects more than 30 million adults in the United States, although formal diagnoses represent only a fraction of this number, according to the American Academy of Sleep Medicine. And while, Dr. Markiewicz is confident the surgery can be beneficial to adults whose long-term health is seriously compromised by their struggle with sleep apnea, his goal is to eventually extend that benefit to children.

While far fewer children experience it, certain conditions can result in sleep apnea in infants, children and teenagers. Risk factors include enlarged tonsils and adenoids, congenital craniofacial abnormalities in the skull or face, obesity and Down syndrome.

“Typically, kids with Down syndrome have very large tongues and their airways are compromised,” Dr. Markiewicz said. “They can have really bad obstructive sleep apnea. Because half of my practice focuses on pediatrics, I’m really excited about the opportunity to perform this procedure on children, especially children with Down syndrome when indicated.” He adds, however, that approval for surgery on children may not be for some time.