Ear, Nose and Throat (Otolaryngology) – Head and Neck Surgery

Sleep Surgery Research

At the Division of Sleep Surgery, patients receive expert evaluation and management of sleep disorders that impact their ability to slumber soundly and feel rested throughout the day, including obstructive sleep apnea (OSA) and sleep-disordered breathing. Led by Dr. Fred Lin, the highly specialized program at Mount Sinai Health System has the only fellowship-trained sleep surgeon in the New York metropolitan area. Our team of otolaryngologists (ear, nose, and throat doctors) are board certified in sleep medicine and industry leaders in developing surgical solutions to treat the nearly half of patients who fail primary therapies for sleep apnea. These breakthroughs are supported by research studies, with the goal of improving outcomes and developing new sleep therapies.

At Mount Sinai, our experts have a storied reputation of treating the most difficult cases of OSA and being on the cusp of developing, studying, and implementing cutting-edge surgical alternatives to treat sleep apnea, including the Inspire Therapy implant device and robotic surgery. Committed to improving the quality of life for every patient, our sleep surgeons are also investigating new drugs for post-operative pain control. We commonly partner with the Division of Rhinology, among other divisions and specialties, to study new treatments, such as budesonide steroid rinses for nasal congestion, which contribute to sleep disturbances.

Inspire Therapy Implant Device

Mount Sinai was one of the first hospitals in New York City to offer the revolutionary implantable device, Inspire. Considered to be a gold standard in the field among patients who have difficulty tolerating CPAP, the device is surgically implanted in the chest during an outpatient procedure and controlled with a remote. Similar to the way a pacemaker stimulates the heartbeat, Inspire reminds the nerve at the base of the tongue to stay forward and keep the airway open each time the patient breathes. This increases the flow of air an individual with OSA receives throughout the night.

Dr. Lin and his colleagues are now implanting the second version of Inspire in patients.

This upgraded device has several notable improvements, including a longer battery life and MRI compatibility. Since the new procedure only requires two incisions, it reduces both pain and recovery time after surgery. Mount Sinai is part of a National Database that collects information about patient outcomes after surgery. Research shows Inspire is successful in nearly 75 percent of patients who fail CPAP. Patients report both improved sleep quality, reduced snoring, and improved cardiovascular risk factors.

Gabapentin for Post-Operative Pain Control

Patients who have sleep apnea surgery generally report varying levels of pain after the operation. Over the last decade, the disturbing increase in opioid addiction and overdose has led the medical community to seek alternative methods for pain control. Originally approved to treat epilepsy, gabapentin is a drug that has also been found to block nerve pain. Research looking at patients who have cancer surgery of the mouth and throat have found that gabapentin decreases both pain and the need for opioids.

At Mount Sinai, our sleep experts are trained in a procedure called uvulopalatopharyngoplasty (UPPP) that treats OSA by removing excess tissue in the throat. Many patients report that UPPP is a particularly painful operation. To improve patient comfort and reduce reliance on opioids, Dr. Lin has studied the use of gabapentin after various sleep surgeries. Early data shows mixed results, but Mount Sinai researchers plan to continue studying alternative methods for pain control.

Robotic Surgery for Sleep Apnea

As one of the first programs in the country to perform robotic surgery for sleep apnea almost ten years ago, Mount Sinai paved the way for new advancements in the field. Our physicians were pioneers in research studies examining moderate and severe tongue-based sleep apnea. Even though Inspire has replaced the need for robotic surgery in many cases of OSA today, the specialized technique is still used in some patients with large tonsil-based tongue obstructions.

Multidisciplinary Approach to Care

We offer a team approach to care, collaborating closely with experts in the Division of Pulmonary and Sleep Medicine, the Division of Oral and Maxillofacial Surgery, the Department of Neurology, and the Metabolic and Bariatric Surgery Program to provide patients with collective expertise for every facet of care. Our sleep experts partner in research with the Division of Rhinology to treat patients suffering from sleep disturbances related to nasal congestion. Dr. Lin is involved in numerous rhinology research studies such as investigating the use of budesonide steroid rinses for patients with chronic rhinosinusitis.