Upper airway surgery addresses the structural causes of Obstructive Sleep Apnoea (OSA) to restore healthy breathing patterns without reliance on external devices.
Upper airway surgery is a collective term for a range of procedures designed to structurally enlarge the pharyngeal airway and prevent it from collapsing during sleep. For the millions of patients with Obstructive Sleep Apnoea (OSA), the collapse of soft tissues in the throat, specifically the soft palate, tongue base, or epiglottis, blocks airflow, causing interrupted breathing and oxygen desaturation.
Unlike CPAP, which acts as a pneumatic splint to force the airway open with air pressure, surgery targets the anatomical root cause of the obstruction. The goal is to remodel or remove these obstructing tissues to maintain a naturally patent airway during sleep.
Modern airway surgery has evolved significantly from the traditional "uvulopalatopharyngoplasty" (UPPP) which often had variable results. Today, we utilise a multi-level approach. This means we assess and treat multiple sites of obstruction simultaneously or in stages. By addressing the specific blockage unique to your anatomy, whether it is a large tongue base, collapsing lateral walls, or elongated soft palate, we aim to significantly reduce the severity of apnoea episodes and restore restorative sleep cycles.
Before any surgery is scheduled, it is critical to understand exactly where your airway is collapsing. Dr Crawford utilises Drug-Induced Sleep Endoscopy (DISE) as a cornerstone of surgical planning.
During a DISE procedure, you are given a light sedative to induce a state similar to natural sleep. Once you are asleep and snoring or obstructing, Dr Crawford passes a flexible endoscope through the nose to directly visualise the airway. This allows her to see precisely which structures are collapsing in real-time.
DISE provides critical data on
Dr Julia Crawford is a leader in utilizing Transoral Robotic Surgery (TORS) to treat complex airway obstructions that were previously difficult to reach without invasive external incisions
TORS allows for unparalleled visualisation and precision when operating on the base of the tongue or the epiglottis. Using the da Vinci® surgical system, Dr Crawford controls miniaturised instruments from a console.
The robotic advantage includes
In addition to robotic surgery on the tongue base, procedures often involve remodeling the soft palate. Modern techniques focus on "reconstruction" rather than "resection" (removal). We aim to stiffen the palate and pull it forward to open the airspace, rather than simply cutting away the uvula, which was common in older techniques. This approach reduces the risk of side effects while maximising airway expansion.
Surgery is not the first line of treatment for everyone. It is typically recommended for patients who have moderate to severe OSA and have not found success with conservative treatments like CPAP or Mandibular Advancement Splints (MAS).
You typically qualify for this procedure if you
Choosing a surgeon for sleep apnoea requires finding a specialist with specific training in both airway anatomy and advanced surgical techniques. Dr Crawford brings a unique combination of academic leadership and international training to her Sydney practice.
Dr Crawford consults at three convenient locations across Sydney.
While your specialist consultations take place at the clinics listed above, the surgical process involves a separate set of mandatory hospital-based appointments. These take place at the facility where your procedure is scheduled, such as St Vincent’s Private Hospital or St George Private Hospital. These appointments are a critical part of the safety protocol for Transoral Robotic Surgery (TORS).
If you are tired of struggling with CPAP or battling constant fatigue, expert help is available. Contact our team today to schedule a consultation with Dr Julia Crawford.
We will review your sleep study, examine your airway, and discuss if a tailored surgical plan is the right path to a restful future.
Our team can assist with appointment enquiries and help arrange a consultation with Dr Julia Crawford at one of her three Sydney consulting locations:
Dr Julia Crawford consults for head and neck conditions, head and neck cancer, thyroid and salivary gland disease, obstructive sleep apnoea, paediatric ENT and selected general ENT problems.
Her team can assist with arranging an appointment at Darlinghurst, Kogarah or Chris O'Brien Lifehouse, and will help ensure the appropriate information and investigations are available before your consultation.