“THREE-IN-ONE” SURGERY TO TREAT SEVERE OBSTRUCTIVE SLEEP APNEA AND SNORING

A middle-aged woman had been experiencing loud snoring, irregular breathing during sleep, frequent nighttime awakenings, persistent headaches, fatigue, and excessive daytime sleepiness. ENT endoscopy revealed a narrowing of the pharyngeal airway — including the soft palate, uvula, tonsils, and tongue base — caused by Grade III tonsillar hypertrophy and uvular prolapse, leading to a diagnosis of severe obstructive sleep apnea (OSA).

Around six months ago, Ms. L.L. (42 years old, Cambodian) began to notice loud snoring and irregular breathing while sleeping, often waking up during the night. These symptoms were accompanied by constant headaches, fatigue, and drowsiness throughout the day, which increasingly affected her health, daily life, and work. Concerned about her declining condition, she sought treatment at Nam Sai Gon International General Hospital.

A flexible nasopharyngoscopy revealed a significant narrowing of the oropharynx caused by Grade III tonsillar hypertrophy and uvular prolapse. This obstruction in the upper airway was the primary cause of her snoring and episodes of apnea during sleep. Additionally, her overweight condition further exacerbated the airway obstruction, worsening the symptoms.

Dr. Le Nhat Vinh, MMed, Specialist Level II – Head of the Multidisciplinary Department and the lead physician in charge, diagnosed the patient with severe obstructive sleep apnea. He recommended upper airway reconstructive surgery to relieve the obstruction and improve airflow during sleep.

The surgical procedure, which lasted over two hours, was performed by Dr. Vinh and his team. It involved electrocautery removal of the hypertrophic palatine tonsils using a monopolar diathermy device; coblation resection of part of the tongue base and lingual tonsils (a technique that uses high-frequency radio waves); and uvulopalatopharyngoplasty (UPPP) to reshape the soft palate and uvula and enlarge the airway.

According to Dr. Vinh, this was a complex case requiring multiple surgical steps to address the coexisting upper airway obstructions. Moreover, the limited operative space inside the patient’s throat made the procedure particularly challenging. Success relied not only on advanced surgical expertise but also on the support of modern surgical equipment to ensure a safe and effective outcome.

The patient recovered quickly with minimal postoperative pain. Remarkably, she was able to speak and consume soft foods within just five hours after the operation. No complications such as bleeding, aspiration, or taste disturbance were observed. The patient reported significantly easier breathing in the supine position and complete resolution of snoring and apnea episodes. After four days of inpatient monitoring, she was discharged in stable condition.

Dr. Vinh noted that obstructive sleep apnea (OSA) is becoming increasingly common but often overlooked due to the misconception that snoring indicates a deep, restful sleep. In reality, untreated OSA can lead to serious health issues, including cardiovascular disease, hypertension, diabetes, sexual dysfunction, and even fatal strokes during sleep.

“If you frequently snore loudly, have difficulty breathing or irregular breathing during sleep, wake up with a dry or sore throat, or experience excessive daytime fatigue, sleepiness, or difficulty concentrating — especially when driving or operating machinery — you should consult an ENT specialist for timely diagnosis and treatment”, Dr. Le Nhat Vinh, MMed, Specialist Level II advised.

Depending on the patient’s condition and preferences, treatment options may include non-invasive therapies such as oral appliances or Continuous Positive Airway Pressure (CPAP) devices, which help keep the airway open during sleep. For suitable candidates, surgical interventions like tonsillectomy and uvulopalatopharyngoplasty may be considered. However, patients seeking surgical treatment should choose reputable hospitals specializing in sleep apnea management to increase the likelihood of success and minimize risks such as bleeding, aspiration, or taste disturbances.

Nam Sai Gon International General Hospital

No. 88, Street No. 8, Trung Son Residential Area, Binh Hung Commune, Ho Chi Minh City.

Hotline: 18006767

info@nih.com.vn

BRC: No. 0312088602, issued on December 14th, 2012 by the Department of Planning and Investment of Ho Chi Minh City. Medical Examination and Treatment License No. 230/BYT-GPHĐ, issued by the Ministry of Health.