Coblation Soft Palate Treatment & Pillar Procedure for Snoring

Coblation Soft Palate Treatment for Snoring

Coblation is a relatively recent technology that has enabled many surgical procedures that previously required IV sedation and even general anesthesia to now be performed under only local anesthesia without any sedation in an office-setting (instead of an operating room). Coblation palatoplasty is used to treat snoring and even mild obstructive sleep apnea in the US.

Methodology

In this procedure, a needle-like device is inserted into the soft palate (see the figure above) and in essence, ‘liposuction’ is performed resulting in an overall reduction in the size and thickness of the soft palate and even the uvula. After 6 weeks, scarring occurs, which stiffens the palate making it less prone to vibration, thereby reducing a person’s snore.

The procedure involves anesthetizing the patient’s back of the mouth with a local anesthesia. After about 20 s, 2% lidocaine with some epinephrine (which helps minimize bleeding) is injected into the soft palate at three spots. Ten minutes later, a coblation wand is inserted into each of these spots for about 10 s. The patient is then discharged after ensuring that there is no bleeding. A short course of antibiotics is prescribed along with pain killers once the effect of anesthesia wears off. S/he is instructed to gargle with saline after every meal for about a week to help keep the wound area clean.

Studies published in peer-reviewed journals have shown the radiofrequency Soft Palate Procedure to have the following clinical advantages:

• Significant post-op improvement in Epworth Sleepiness Scales at both the 3- and 9.5-month postoperative visits.
• Significant reduction in snoring reported by both the patient and bed partner at the 3- and 9.5-month post-operative visits.¹
• Minimal patient discomfort.
• Immediate volumetric palatal tissue removal.
• Continual symptomatic improvement over time due to tissue shrinkage as a result of submucosal lesion being formed.

Pillar Procedure

The Pillar Procedure is an alternative but similar procedure apart from being a simple and effective treatment for sleep apnea and snoring. This procedure is less invasive and less painful than other surgical procedures, is completed in a single, short office visit and is FDA-cleared and clinically proven, with results comparable to more aggressive surgical procedures. Most patients soon report a drastic reduction in snoring and less daytime sleepiness. In clinical studies, nearly 80% of patients’ sleep apnea was reduced.

Methodology

The Pillar Procedure also targets the Soft Palate, one of the anatomical components of sleep apnea and snoring.

Resources

• AASM – Accredited Member Centers and Laboratories: Find a Sleep Center (American Academy of Sleep Medicine)
• American Academy of Otolaryngology–Head and Neck Surgery
• Subjects trial by Armstrong et al. confirmed by evidence from Gall et al.^[6], Cartwright and Knight^[7] and Fitzpatrick et al.^[8]
• http://en.wikipedia.org/wiki/Snoring
• homepage.mac.com/changcy/palatoplasty.htm
• http://www.snoringcenter.com
• http://dentalimplants-usa.com

Snoring

Snoring is the act of breathing through the open mouth, occurring mostly while asleep, in such a way as to cause a vibration of the uvula and soft palate, thus giving rise to a sound varying from a soft noise to a loud unpleasant sound. It can be due to obesity, enlarged tonsils and adenoids, deformities in the nasal passages, etc. It is basically caused by some kind of blockage in the breathing passage such as the tongue rolling into the throat during sleep or allergies or throat weakness causing the throat to close during sleep or mispositioned jaw, often caused by tension in the muscles or may be due to fat gathering in and around the throat. Numerical statistics on snoring are often contradictory, but at least 30% of the adults and perhaps as many as 50% of people in some demographics snore. The loudest snore on record was of 93 decibels. Most of the time snoring is not a health risk to the snorer, but snoring resulting from a significant obstruction of the breathing passage can be an indication of the potentially life-threatening disorder called sleep apnea.

IMPACTS OF SNORING

According to Dr William C Dement of the Stanford Sleep Center, anyone who snores and has daytime drowsiness should be evaluated for any of the sleep disorders such as (a) sleep deprivation, (b) daytime drowsiness, (c) irritability, (d) decreased libido, (e) psychosocial damage, (f) risk of heart attack (about +34% chance) associated with loud snoring, (g) atherosclerosis of carotid artery due to turbulence in the blood flow caused by loud snoring leading to the risk of a stroke (about +67% chance) and/or (h) severe impairment of lifestyle like marital conflicts. 

SURGERY

Alleviating snoring nearly revolves around clearing the blockage in the breathing passage. In addition to the palate, tongue size, enlarged tonsils, a large uvula or nasal obstruction can all be contributing factors to a patient’s snoring. Hence the snorers are advised to lose weight (to stop fat from pressing on the throat), to stop smoking (smoking weakens and clogs the throat) and to sleep on their side (to prevent the tongue from blocking the throat). Different aids work for different people. Surgery is one option to cure snoring (e.g. a uvulopalatopharyngoplasty); while usage of dental appliances such as a mandibular advancement splint is another. Nose clips are also used to keep the nose open and jaw mechanics to keep the jaw in the right position.