Advanced Palate Surgery: What Works?

To describe the current knowledge about palate surgery in obstructive sleep apnea (OSA). Basic and advanced surgical techniques developed during the last years will be illustrated. Palate surgery has evolved from ablative and aggressive surgeries to more selective and conservative surgery. Minimally invasive surgery has a role in palate surgery, including radiofrequency of the soft palate that can be performed in the office. Nevertheless, invasive techniques may be more effective in the long term. From tonsillectomy to modern lateral wall addressing pharyngoplasties have shown some good results in selected OSA patients. Several randomized controlled trials and meta-analysis are reviewed. A description of each technique is included. Selecting a successful surgical approach depends on many factors such as the age of the patients, AHI severity, patient’s airway collapse pattern, body mass index, surgeon experience, and patient’s preference. It is important to discuss also surgical treatment expectations and outcomes. Lateral wall addressing pharyngoplasties have shown best results in OSA patients.