Successful surgical management of obstructive sleep apnea (OSAS) requires a thorough understanding of the pathophysiology and anatomical contributions to this widely variable disease. Early efforts to surgically correct OSAS involved bypassing the upper airway; thus, indirectly improving the symptoms without directly addressing the pathophysiology. Surgical procedures to treat OSAS have evolved over the past several decades as further understanding of the disease continues to be elicited. The surgical techniques employed in the treatment of OSAS are quite varied. Many surgical subspecialties have contributed to the understanding of the complexities of OSAS. Recent surgical management involves site-specific alterations of the upper airway to more directly address the disease process. In addition, current literature suggests an algorithmic and phased approach to the treatment of OSAS. Future technology offers the hope of better diagnostic and therapeutic options for the surgical management of OSAS.
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