One of the common perceptions about surgery for sleep apnea is that it can be risky in the per0operative period. This is why many surgeons still observe patients who undergo UPPP or tongue base procedures in the intensive care unit overnight (ICU). A new retrospective study looking at almost 1700 procedures of the nose, palate and tongue determined that it’s not as risky as one may think. Patients that underwent tongue base procedures were admitted to a type of ‘step-down” unit for over-night observation. Overall, the complication rate was 7.1%, with most of these being minor and resolving with conservative treatment (typically transient high blood pressure or a drop in oxygen levels). Swelling of the tongue after suspension suture placement also resolved with conservative treatment. Only one patient required re-intubation for tongue base swelling. Complication rates were no different when they analyzed severity of sleep apnea or oxygen desaturation levels.
My personal experience over the last 10 years mirror these findings. So far, I haven’t had the need to admit patients to the ICU after sleep apnea surgery. With good surgical technique and nursing care, most of these patients can be observed on the regular inpatient floors. Of course, there will always be exceptions to the rule, and the decision to admit to the ICU has to be made on an individualized basis.