Stanford Protocol

The Stanford Protocol is a combination of surgeries designed to treat obstructive sleep apnea (OSA). Developed at Stanford University, the protocol consists of two phases, each involving different surgical procedures aimed at reducing airway obstruction during sleep.

Phase 1

In the first phase of the Stanford Protocol, patients undergo uvulopalatopharyngoplasty (UPPP), a procedure that removes excess tissue from the throat to widen the airway. In addition to UPPP, one or more of the following surgeries may also be performed during this phase: Genioglossus Advancement (GA) – This procedure advances the tongue's attachment point on the lower jaw, preventing the tongue from collapsing backward and obstructing the airway during sleep. Hyoid Suspension (HS) – This surgery aims to stabilize the hyoid bone, a horseshoe-shaped bone in the neck, to reduce airway collapse.

Phase 2

If the first phase of the Stanford Protocol does not produce satisfactory results, patients may undergo a second phase, which involves maxillomandibular advancement (MMA). MMA is a surgical procedure that moves the upper and lower jaws forward to increase the size of the airway and reduce the likelihood of obstruction during sleep.

Candidates and Outcomes

The Stanford Protocol is typically reserved for patients with moderate to severe OSA who have not responded to conservative treatments, such as continuous positive airway pressure (CPAP) therapy or lifestyle changes. The success rate of the Stanford Protocol varies, but it has been shown to significantly improve OSA symptoms in many patients, including reducing the number of apnea and hypopnea events and improving overall sleep quality.