Lung Disorders Special Report
The Facts Behind Pillar Palatal Implants
Dr. Peter B. Terry, Professor of Medicine at Johns Hopkins’ Division of Pulmonary and Critical Care Medicine, explains how pillar palatal implants act to reduce snoring.
If snoring is keeping you awake -- not to mention your long-suffering family -- you may be desperate for ideas to stop that unending nighttime noise. There are many options beyond taping a tennis ball to your back to keep yourself from rolling into a snoring position. You can have surgery to remove part of the soft palate at the back of your throat, or have other procedures to immobilize it.
One of the newest options to stop snoring, a device known as the Pillar palatal implant, reduces the fluttering of soft tissue responsible for snoring in much the same way that battens reduce the fluttering of a sail on a boat’s mast at sea. Three polyester braids, each less than an inch long, are embedded in the back of the throat to stiffen the soft palate and reduce the vibration that causes snoring. According to the company that manufactures the implants (Restore Medical of St. Paul, Minnesota), because of its simplicity, low discomfort, and favorable results, the procedure stacks up favorably when compared with the other options. These include:
- Snoring option 1: Continuous positive airway pressure (CPAP) -- placement of a tight-fitting mask over the nose at night, through which air is delivered under pressure
- Snoring option 2: Uvulopalatopharyngoplasty (UPPP) -- removal of part of the soft palate, uvula, and tonsils to open the airway
- Snoring option 3: Laser-assisted uvulopalatoplasty (LAUP) -- removal of part of the soft palate using a laser to open the airway
- Snoring option 4: Radiofrequency ablation -- thermal destruction of soft palate tissue using radiofrequency
- Snoring option 5: Sclerotherapy -- injection of an irritant to harden the soft palate
Here’s how the implant procedure works: The doctor numbs the area with a local anesthetic, then embeds the inserts in the soft palate using a specially designed tool. The company says discomfort is minimal because tissue is not removed or damaged, and that most patients report a noticeable and lasting reduction in snoring. The implant procedure requires only one office visit.
Will the implants help sleep apnea? Restore Medical says that the implants should help prevent snoring from obstructive sleep apnea by preventing the flapping of the soft palate from closing off the airway. However, the jury is still out on this question, which is an important one because obstructive sleep apnea is potentially life-threatening.
One recent study presented at a meeting of the American Academy of Otolaryngology–Head and Neck Surgery raised the issue but did not resolve it. Doctors from the Lahey Clinic in Burlington, Massachusetts, reported their results after inserting the implants into 25 patients with “socially unacceptable snoring” (as defined by patients and their bed partners). The researchers found that the implants were safe, with no complications resulting from the implant procedure, and effective, achieving a significant reduction in the loudness of snoring. However they noted that further studies should be done to address the "emerging role” of the implants in treating sleep apnea.
The Bottom Line: If you’re considering palatal implants to reduce snoring, your first step should be to ask your primary care physician to arrange for you to spend a night in a hospital sleep laboratory for a sleep study. This overnight procedure will help determine whether you have sleep apnea in addition to snoring. Once you know whether you’re simply a snorer or have more complicated sleep-related problems, the next step is to have a consultation with a board-certified sleep specialist. This expert can walk you through the pros and cons of palatal implants versus other forms of therapy, to help you -- and others nearby -- to enjoy that ordinary luxury: a good night’s sleep.
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Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Johns Hopkins Health Alerts Disclaimer
Posted in Lung Disorders on October 25, 2007
