For Sleep Apnea, robotic Surgery offers a New tool

Using a new technique made possible by robotic technology, Jeffrey Ahn, M.D., is helping some sleep apnea sufferers ditch the CPAP machine and catch some Zs. Judith Oderwald is one of them. After eight years of struggling with her CPAP machine, she decided it was time to find another solution to her obstructive sleep apnea.

"I had enough of the machine. You’re fighting with the hose all the time. I switched to a machine that uses a tube that goes up the nose, but that would slip out. And I was still exhausted," says Mrs. Oder- wald, a 69-year-old retiree from New Hyde Park on Long Island.

It was not surprising to Dr. Ahn, director of sleep disorder & robotic surgery at Columbia, that Mrs. Oderwald had trouble tolerating CPAP (continuous positive airway pressure). "CPAP works as long as patients wear it, but it’s cumbersome and about 50 percent of people who try it eventually quit," he says.

While researching other options, Mrs. Oderwald read about a new robotic surgical procedure that can now help. Her family physician referred her to Dr. Ahn, assistant professor of clinical otolaryngology- head & neck surgery, one of the few surgeons in the United States certified to perform the procedure.

Three common areas of the airway can become obstructed during sleep: the nose, the palate, and the base of the tongue. It is simpler to surgically remove excess tissue from the nose and palate, but sur- geons have difficulty reaching down into the throat to remove tissue from the tongue base.

"The surgeon cannot see well and human hands are too big," says Dr. Ahn. Many people with severe obstructive sleep apnea have obstructions in all three regions, so the surgeon addresses the nose and palate first and then uses the robot to remove excess lymphoid tissue in the tongue base.