Wednesday, October 28, 2009

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


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