Surgery for snoring
We all snore occasionally. Around 44% of males and 28% of females aged between 30 and 60 years are habitual snorers. Habitual snoring is a marker for sleep apnea syndrome. Sleep apnea syndrome may increase the risk of high blood pressure, heart failure, stroke, and/or daytime sleepiness. Hence, the management of snoring and resultant sleep apnea is important.
Snoring occurs because of increased vibration in the throat tissues. This happens when the muscles of the throat collapse in sleep. Snoring may result in:
- Restless sleep
- Night awakening
- Morning fatigue
- Daytime sleepiness
- Hypoxemia (low levels of oxygen in the blood)
There are several conservative approaches to treat snoring, including:
- Weight loss
- Sleeping on the side of your stomach rather than on the back
- Using nasal drops
- Using nasal dilators
- Avoiding alcohol within 3 hours of bedtime
Most doctors prefer managing snoring medically. Surgical methods to treat snoring are reserved for extreme cases or people with crooked noses or nasal polyps.
Some of the most common surgical procedures used to treat snoring include:
- Nasal surgery: Obstruction in the nose can cause the person to snore. Some of the nasal surgeries that can relieve snoring include:
- Correction of enlarged inferior turbinates: Nasal turbinates are long, narrow passageways that warm and moisten the air that flows in through the nose. Swollen turbinates often cause swelling.
- Septoplasty: This procedure corrects the deviated septum or the dividing wall that separates two chambers of the nose.
- Soft palate procedure: When the person snores, the soft palate vibrates and produces snoring sounds. Many procedures have been developed to fix the soft palate and limit its vibration. The various techniques include:
- Pillar procedure: In this procedure, the physician inserts three to five braided polyester implants into the soft palate present at the back of the mouth, which results in widening of the area.
- Soft palate radiofrequency: This technique utilizes radiofrequency to create damage in the soft palate. During the healing process, the scar tissue stiffens the soft palate. The two most common radiofrequency technologies are:
- Laser-assisted uvulopalatoplasty: It involves removing the soft tissue from the back and top of the throat using a laser.
- Tonsillectomy and adenoidectomy: Removing tonsils or adenoids can provide relief from snoring.
- Maxillomandibular advancement (MMA): This procedure moves the upper and lower jaws forward surgically, which helps open the airway.
- Hypoglossal nerve stimulation: This technique involves stimulating the nerve that controls the forward movement of the tongue. Thus, it prevents the tongue from falling back during sleep.
- Genioglossus advancement: In this procedure, the tongue muscle that is attached to the lower jaw is pulled forward. It makes the tongue rigid and less collapsible during sleep.
However, there is always a risk of infections and complications with the surgery. Many surgeries may result in a nasal twang, nasal reflux, and considerable pain immediately after the procedure. The surgeries do not address the root cause of the problem, but they mask the sleep apnea symptom, which is dangerous.
Therefore, the surgical approach should only be used as the last resort to manage snore.
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Stanford Health Care. Genioglossus Advancement. https://stanfordhealthcare.org/medical-treatments/t/tongue-surgery/types/genioglossus-advancement.html
Mayo Clinic. Snoring. https://www.mayoclinic.org/diseases-conditions/snoring/diagnosis-treatment/drc-20377701
Rowley JA. Snoring in Adults. UpToDate. https://www.uptodate.com/contents/snoring-in-adults?search=How%20Effective%20Is%20Laser%20Treatment%20for%20Snoring&source=search_result&selectedTitle=1~150&usage_type=de
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