Injection snoreplasty is perhaps the least expensive among expensive surgical options available to significantly improve if not cure snoring. The key to a great outcome from this procedure is patient selection as the procedure itself is quite straightforward and done in an office-setting under local anesthesia without any sedation.
The Perfect Patient
The perfect patient who would most benefit from this procedure is someone who snores due mainly to palatal vibration and does not have a bad gag reflex. The best way to determine whether the palate is the main culprit in a patient's snore is by having him/her imitate the snore while the palate is being examined. How is this accomplished? The patient should bring his/her partner and reproduce the snore with his/her partner's confirmation. While the snore is reproduced, fiberoptic nasopharyngoscopy is performed and if the soft palate is shown to be vibrating, injection snoreplasty would be of benefit.
For most people, a "palatal" snore that is amenable to this treatment sounds like this:
Sample Uvula/Palate Snore #1
Sample Uvula/Palate Snore #2
A tongue base snore that sounds like this does not respond well to this type of treatment:
Sample Tongue Base Snore
If you are able to imitate the snore while sticking out the tongue, the snore is most likely from the uvula/palate.
The procedure is performed in the following manner:
The back of the mouth is anesthetized with topical 4% lidocaine.
After the area is anesthetized, 1-3 injections are performed to the base of the uvula with a sclerosing agent (such as 50%-75% ethanol). The sclerosing agent causes the tissues to ulcerate over the next few minutes to hours.
Obviously, if the patient has a bad gag reflex, this step would be quite difficult to do.
The first few days, the soreness is most severe and narcotics are prescribed to help with the pain. After about 1 week, the soreness usually is almost completely resolved.
The ulcer which appears (and even a hole may occasionally occur) slowly heals over the next few weeks which causes scarring and contracture. This scarring and contracture stiffens and shortens the palate making it more stiff and less likely to vibrate causing a significant decrease in snoring and in many patients, a cure.
About 50% of patients would benefit from another injection 6-8 weeks later. Overall, about 80% report significant improvement (not necessarily cure) in their snoring.
It is not unusual to have some snoring recurrence within the next 5 years at which time this procedure can be repeated.
However, even with these maneuvers, snoring may not completely go away as snoring may be due to many different other levels of the airway (ie, tongue vibration, nose vibration, cheek vibration, throat vibration, etc). Click here for more info.
Another issue to keep in mind is that snoring is considered a COSMETIC problem and as such, any procedures used to treat snoring surgically will be an out-of-pocket expense for patients. Click here to see what the cost will be. The patient will have to obtain the sclerosing agent that will be injected from a pharmacy (prescription will be provided).
However, snoring may be indicative of an underlying medical condition like obstructive sleep apnea (OSA) for which treatment IS covered by insurance. Treatment for OSA often helps snoring as a bonus side effect. In order to determine if a person's snore is due to OSA, a sleep study needs to be performed which can only be prescribed by a physician. Watch the video below to see how a sleep study is performed at a sleep center.
If snoring and/or obstructive sleep apnea is affecting your quality of life, please contact our office for an appointment.
Commonwealth Sleep Center and Fauquier Health Sleep Center performs sleep studies in our area. The video below was done at the Commonwealth Sleep Center in Gainesville, VA. If you are unable to view video, click here.
More Videos on ENT Topics
- Single dose injection snoreplasty: investigation or treatment? J Laryngol Otol. 2008 Nov;122(11):1190-3. Link
- Radiofrequency versus injection snoreplasty in simple snoring. Otolaryngol Head Neck Surg. 2005 Aug;133(2):224-8. Link
- Injection snoreplasty: investigation of alternative sclerotherapy agents. Otolaryngol Head Neck Surg. 2004 Jan;130(1):47-5. Link
- Injection snoreplasty: extended follow-up and new objective data. Otolaryngol Head Neck Surg. 2003 May;128(5):605-15. Link
- Injection snoreplasty: how to treat snoring without all the pain and expense. Otolaryngol Head Neck Surg. 2001 May;124(5):503-10. Link
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