The purpose of snoring surgery is to improve or eliminate the medical and social consequences of heavy snoring.
There are several procedures to choose from:
Uvulopalatopharyngoplasty (UPPP) is the oldest and most invasive surgical treatment for snoring. The surgeon removes the patient’s tonsils, part of the soft palate, and the uvula. The procedure works by enlarging the airway and removing some of the soft tissue that vibrates when the patient snores. It is not effective in treating snoring caused by obstructions at the base of the tongue.
UPPP has several drawbacks in addition to its cost and lengthy recovery period. It can result in major complications, including severe bleeding due to removal of the tonsils as well as airway obstruction.
Laser-assisted uvulopalatoplasty (LAUP) is an out-patient surgical treatment for snoring in which a carbon dioxide laser is used to vaporize part of the uvula, a small triangular piece of tissue that hangs from the soft palate above the back of the tongue. The patient is seated upright in a comfortable chair in the doctor’s office. The doctor first sprays a local anesthetic over the back of the patient’s throat, covering the patient’s soft palate, tonsils, and uvula. The second step is the injection of more anesthetic into the muscle tissue in the uvula. After waiting for the anesthetic to take effect, the surgeon uses a carbon dioxide laser to make two vertical incisions in the soft palate on either side of the uvula. A third incision is used to remove the tip of the uvula. The surgeon also usually removes part of the soft palate itself. The total procedure takes about half an hour.
LAUP is typically performed as a series of three to five separate treatments. Additional treatment sessions, if needed, are spaced four to eight weeks apart.
Somnoplasty, or radiofrequency volumetric tissue reduction (RFVTR) is a newer technique in which the surgeon uses a thin needle connected to a source of radiofrequency signals to shrink the tissues in the soft palate, throat, or tongue. The needle is inserted beneath the surface layer of cells and heated to the appropriate temperature. The upper layer of cells is unaffected, but the heated tissue is destroyed and gradually reabsorbed by the body over the next four to six weeks. Somnoplasty stiffens the remaining layers of tissue as well as reducing the total volume of tissue. Some patients require a second treatment, but most find that their snoring is significantly improved after only one. The procedure takes about 30 minutes and is performed under local anesthesia.
Tongue suspension procedure
The tongue suspension procedure, which is also known as the repose system, is a minimally invasive surgical treatment for snoring that stabilizes the base of the tongue during sleep, preventing it from falling backward and obstructing the airway. It consists of a titanium screw inserted into the lower jaw on the floor of the mouth and a suture passed through the base of the tongue that is then attached to the screw. The attachment holds the tongue forward during sleep.
The Repose system is done as an outpatient procedure under total anesthesia. It takes about 15â€“20 minutes to complete. The advantages of the tongue suspension procedure include the fact that it is reversible, since no incision is made; and that it can be combined with UPPP, LAUP, or a tonsillectomy . Its disadvantages include its relatively long healing time (one to two weeks).
In injection snoreplasty, the surgeon gives the patient a local anesthetic and then injects a hardening agent known as sodium tetradecyl sulfate underneath the skin of the roof of the mouth just in front of the uvula. The chemical, which is also used in sclerotherapy, creates a blister that hardens into scar tissue. The scar tissue pulls the uvula forward, reducing the vibration or flutter that causes snoring.
You may be given oxygen from a face mask for a few hours if you have had any chest problems in the past. Usually the nose will be a little sore and uncomfortable after this operation. While the packing is in your nose you will have to breathe through your mouth, and this will make your mouth feel dry. Taking frequent drinks will help to keep it moist. You may find that the nasal packing makes your eyes water.
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RecoveryYou may be given oxygen from a face mask for a few hours if you have had any chest problems in the past. Usually the nose will be a little sore and uncomfortable after this operation. While the packing is in your nose you will have to breathe through your mouth, and this will make your mouth feel dry. Taking frequent drinks will help to keep it moist. You may find that the nasal packing makes your eyes water.