Surgery for snoring is a treatment of last resort and should only be considered if the simple non-surgical alternatives have been tried (and failed). Before embarking on palatal surgery you should be sure that the snoring originates from the palate as opposed to the base of the tongue. If you have nasal abnormalities these should also be addressed before contemplating palatal surgery.
The aim of palatal surgery is to reduce or stop the collapsibility of the oropharyngeal segment (area around the throat). This is usually done by reducing the amount of soft palate and/or removing the tonsils. Surgery is also undertaken to remove the chief vibratory tissue (the uvula).
Some surgeons advocate sleep nasendoscopy before surgery is undertaken to determine the level of obstruction. Here the patient is sedated to a state of sleep. The surgeon can then examine the upper airway through a narrow flexible endoscope to see where the collapsing is occurring. This procedure however is not widely available as it is time consuming and costly.
There are four basic surgical procedures:
- Uvulopalatopharyngoplasty (UPPP)
- Laser-assisted uvuloplatoplasty (LAUP)
- Platal stiffening operations (CAPSO)
- Radio-frequency ablation (Somnoplasty)
Other procedures include:
- Injection Snoreplasty
- Pillar Procedure
The choice of which operation is less important as there are arguments for and against each method. What is more important is that surgery is the right treatment for you.
Some important points that you should remember before undertaking surgery:
- After the operation you will experience pain.
- Surgery for snoring should never be carried out without a prior sleep study.
- Surgery is a treatment of last resort; try everything else first.
- There is no guarantee of success.
- Even if initially successful, snoring can return after a few months.
- Snoring may not be associated with the soft palate at all. It could occur at the base of the tongue. Without full diagnostic procedures it is not possible to differentiate. Surgery will not eradicate tongue based snoring.
- Surgery for snoring is available on the NHS.
- Following a sleep study, surgery should not be considered unless you fit the following criteria: low alcohol intake, non-obese, tonsils still present, and correct jaw shape.
- Even if you do comply with the above, you are advised that there are many short and long term limitations to such procedures.
- If you put on weight after your surgery especially around the neck area you are likely to resume your snoring.
- Remember, you may still go on to develop sleep apnoea in the future especially if you put on weight. Surgery may mask the development of sleep apnoea.
- Surgery is not always effective in patients with a deep oropharynx where the side walls tend to collapse towards each other.
- Once you have undergone a surgical procedure it cannot be reversed. You may experience unwanted side effects as a result of the surgery.
- Surgery is very rarely undertaken for the treatment of sleep apnoea. CPAP therapy is the recommended course of treatment for sleep apnoea, but it is also affective for snoring if the simple remedies have not worked for you.