Midline glossectomy is a surgical procedure used to treat obstructive sleep apnoea (OSA) and snoring, particularly when the tongue base is a major contributor to airway obstruction during sleep. The procedure removes a central strip of tissue from the back of the tongue via the mouth to create more space and reduce airway collapse.
It is often performed as part of multilevel surgery alongside other procedures such as uvulopalatopharyngoplasty (UPPP), Transpalatal Advancement (TPA), or nasal surgery, depending on the level(s) of airway narrowing.
Midline glossectomy may be recommended if you have:
This procedure is typically offered when non-surgical measures have not been successful or are poorly tolerated.
As with any surgical procedure, there are associated risks:
These risks will be discussed with you by Dr Phillips based on your specific anatomy and clinical context.
Non-surgical treatment options include:
These options may be trialled first or used in combination with surgery.
Seek urgent care if you experience:
You will be reviewed by Dr Phillips 1–2 weeks post-operatively. If further sleep testing is required, this will be arranged to assess the outcome of your surgery.
Murphey AW, Kandl JA, Nguyen SA, Weber AC, Gillespie MB. The Effect of Glossectomy for Obstructive Sleep Apnea: A Systematic Review and Meta-analysis. In: Otolaryngology – Head and Neck Surgery (United States). SAGE Publications Inc.; 2015. p. 334–42.
Surgery can significantly reduce symptoms and improve sleep, especially in patients with tongue-related obstruction. Complete resolution may not occur in all patients, particularly if other levels of obstruction exist.
A 2015 systematic review and meta-analysis of 18 studies (522 patients) evaluating glossectomy techniques, including midline glossectomy, showed:
• AHI reduced by 27.8 events/hr (average)
• Epworth Sleepiness Scale improved by 5.5 points
• Snoring improved by 5.6 points on a visual analogue scale
• Lowest oxygen saturation (LSAT) improved by 7.7%
• Complication rate: 16.4%, with taste change (5.8%) and bleeding (4.2%) being the most common, usually temporary
These findings support the use of midline glossectomy as an effective part of multilevel airway surgery.
Possibly — but surgery often makes CPAP easier to tolerate or reduces the pressure required. In some cases, it may no longer be necessary.
Yes, but manageable. Pain peaks around days 5–7 and improves with regular medication and hydration. Pain relief and hydration are key to recovery.
Mild, temporary changes are common. Permanent changes are rare, especially with modern techniques that preserve tongue function and sensation.
If you’d like to discuss this procedure or explore suitable treatment options, please get in touch with Dr Nicholas Phillips’ clinic.
To book with Dr Phillips, you’ll need a referral from your GP or specialist. Questions? Call our team — we’re happy to help.
