Lower airway surgery is normally done for two reasons - to increase the size of the airway to improve breathing and to prevent the airway from collapsing. It also helps to minimize or prevent snoring for sleep apnea sufferers.
There are several types of lower airway surgery:
Genioglossus Advancement
The muscle called the genioglossus connects the back of the tongue to a spot on the rear of the chin. Genioglossus advancement moves the tongue forward to leave more space for air to circulate. This surgery is done via an incision inside the patient's lower lip.
Hyoid Advancement
Slightly above the Adam's apple is a C-shaped bone called the hyoid bone. This bone connects the muscles at the edge of the lower throat to the back of the tongue.
Hyoid advancement surgery is done to increase the space behind the tongue, allowing air to flow more freely. In this procedure, an incision is made in the hyoid bone which is then brought forward and attached to either the jawbone or the Adam's apple.
Lingualplasty
In some cases, the reason air is obstructed is because the tongue is too big. In a surgical procedure called a midline glossectomy, a small part of the center of the tongue is removed to make it smaller.
Lingualplasty is a similar procedure, with even more of the tongue being removed. In some cases, a temporary tracheostomy may be performed to ease breathing during recovery because of the swelling that takes place.
Bimaxillary Advancement
In some cases, the doctor will move both the upper and lower jawbones forward, including the patient's teeth. This increases the space for the tongue to rest and improves airflow. This procedure is called bimaxillary advancement and is usually either performed when the patient has a small jaw or when they have not had any improvement from other soft tissue surgeries.
Realignment of the teeth is sometimes necessary after this surgery, which requires orthodontic work. It can also affect the facial appearance, but to what degree will depend on how severe the work was.