There are several surgical options available to address snoring. In this section, we will discuss some of the treatment options for snoring.
Snoring is sound created by vibration of tissue in the throat (usually the soft palate, or back section of the roof of the mouth) during sleep. There are a number of treatment options, including conservative steps like weight loss, sleeping on your side or stomach rather than on your back, and avoiding alcohol within 3 hours of bedtime. Surgery can also be very effective, especially when combined with these basic approaches. Just like with sleep apnea surgery, the key with snoring surgery is to figure out what is causing the snoring and coming up with a plan that matches the person who snores. The most common snoring procedures are those that involve the nose or the soft palate.
Blockage in breathing through the nose can be an important part of snoring. While the nose itself does not vibrate to cause the snoring sound, blockage in the nose can set someone up to snore—and opening up breathing through the nose can make a major difference. Non-surgical options to nasal blockage start with something as basic as salt water spray (nasal saline) twice a day and can include medications such as nasal steroids or nasal dilator strips. Surgery can include correction of enlarged inferior turbinates (with turbinate reduction) or a deviated septum (with septoplasty).
Because the soft palate is often the structure inside the mouth that physically vibrate to cause the snoring sound, many procedures have been developed to stiffen the soft palate and limit this vibration. This is the area that is widened with the use of a snoring device.These include the Pillar Procedure, soft palate radio frequency, and techniques that remove tissue or use special stitches.
The Pillar Procedure typically involves the insertion of 3-5 braided polyester implants (pillars) into the soft palate at the back of the mouth. Each implant is 18 mm (3/4 inch) long and is made of a polyester material that has been used in other medical implants for decades. The Pillar Procedure is usually performed in a surgeon’s office, using local anesthesia to numb the soft palate, followed by placement of the implants. More-recent research has examined the benefits of the Pillar Procedure, showing that there are certain patients that seem to benefit more than others. The most-favorable patients tend to be those with small tonsils (or who had them removed already) and who are not excessively overweight.
Radiofrequency is controlled cauterization that a surgeon delivers to the soft palate with a special instrument. The idea behind soft palate radiofrequency is to create some damage in the soft palate with the procedure, allowing the healing process to create some scar tissue to stiffen the soft palate. Usually it is done in 2-3 treatment sessions and is also performed in a surgeon’s office. There are multiple radiofrequency technologies available, and the two most common are Somnoplasty and Coblation,
Many soft palate procedures for snoring can be performed in the office. The many different techniques have never been compared directly against each other, but they share a common approach to removing or repositioning tissue with a combination of cutting or specific use of stitches.
Dr. Eric Kezirian, MD, MPH is a sleep surgeon and Professor in the USC Caruso Department of Otolaryngology – Head & Neck Surgery at the Keck School of Medicine of USC in Los Angeles, California. He is also the immediate past President of the International Surgical Sleep Society.
© 2021 American Sleep Association.