Lingual Tonsillectomy for Obstructive Sleep Apnea

Lingual tonsillectomy for obstructive sleep apnea is a broad category of procedures to help reduce excess tissue or overall tongue size. This improves air passage during sleep.

Past procedures included removing part of the actual tongue muscle. New technology, like the Inspire system, means this method is uncommon today. A more common problem that does need to be addressed directly using tissue surgery for this area is lingual tonsil hypertrophy.

Frequently Asked Questions About Lingual Tonsillectomy

The tonsils are a grouping of three sets of tissue in the back of the throat. The traditional tonsils (palatine tonsils) are located on each side of the throat when you look in the mouth. They usually reach maximum size during childhood but can be persistently enlarged and cause infections in adulthood.

The adenoids are a set of tonsils behind the nose that grows during childhood and usually shrink to a minimal size without causing any issues. They rarely need removal during adulthood. The lingual tonsils are located on the back of the tongue and can be enlarged in adults. They are removed using a procedure called a lingual tonsillectomy.

You must first undergo a medical evaluation to review your past sleep study records, medical history and in many cases have a diagnostic evaluation with a drug induced sleep endoscopy.

Some patients have blockage of the airway due to enlarged lingual tonsils. In cases severe enough to block the airway, this can cause sleep apnea.

  • Lingual tonsillectomy surgery is performed under general anesthesia in the operating room.
  • During the procedure, the airway is approached through the mouth using a device to visualize the throat.
  • A breathing tube is passed through the nose to allow space in the mouth to perform the surgery.
  • The lingual tonsils are typically removed separately from the palatine tonsils to avoid abnormal scar tissue forming.
  • A small endoscope or camera is placed in the mouth and a radiofrequency device called a coblator is used to reduce the size of the tonsil tissue safely.
  • The tissue is reduced in size, but not completely removed to protect important nerves and blood vessels.

After surgery, patients are kept overnight at the hospital for observation and pain control. Your care team will give you clear, detailed care instructions and an appointment will be scheduled one week after surgery.

  • You should expect to be off work for about one to two weeks and no heavy lifting or vigorous activity for two weeks.
  • During this time, you will be provided pain medication and rinses to help your throat heal.
  • Eat a soft diet during this time. Protein shakes are a helpful nutrition supplement.
  • It is important to monitor for any bleeding. If this occurs go to the emergency room for evaluation.

Additional appointments will be scheduled one month after surgery and again at three months for additional testing. Once effective treatment is confirmed, patients typically follow up once a year to ensure their sleep apnea symptoms are not returning and no new issues are arising.

Pain with a lingual tonsillectomy is less than a traditional tonsillectomy since the throat muscles are not exposed. You will receive adequate pain medication in the postoperative period. At your one-week follow-up appointment, your physician can help you address any issues with your recovery.

The surgical changes are permanent and designed to last for years. However, weight changes can affect anatomy.

Patients need to refrain from heavy lifting for two weeks after surgery to prevent complications. After that, you may return to all normal activities, including sports.

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