Type of Surgery
Information
Last updated: 11/24/2009
Mortality rates for UPPP are related to complications of OSA rather than to the procedure itself. With regard to the outpatient procedures for snoring, mortality rates are very close to zero because these surgeries are performed under local anesthesia....
Complication rates, however, are high with both UPPP and LAUP. According to one European study, as many as 42% of patients have complications following UPPP, with 14% reporting general dissatisfaction with the results of surgery. Specific complication rates for UPPP are 15% for recurrence of snoring; 13% for nasal regurgitation; 10% for excessive throat secretions; 9% for swallowing problems; and 7% for speech disturbances. Complications for LAUP have been estimated to be 30–40% for recurrence of snoring; 30% for causing or worsening of OSA; 5%–10% for persistent nasal regurgitation; 1% for permanent change in vocal quality.
As of early 2003, no morbidity figures have been published for somnoplasty or injection snoreplasty.
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A physician explains some of the most common sleep disorders like insomnia, narcolepsy, and restless legs syndrome. The video begins by explaining the process of sleep and what occurs in the brain as we sleep. Video and graphic animations are used as teaching tools throughout.
Heavy snorers have their air flow impeded by the structures at the back of the mouth and nose (A and B), which can be alleviated by surgery. In uvulopalatopharyngoplasty, the patient's uvula, soft palate, and tonsils are removed (C and D). (Illustration by GGS Inc.)
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Surgery is also available as a method of correcting social snoring. Some procedures, such as uvulopalatopharyngoplasty, attempt to widen the airway by removing tissues in the back of the throat, including the uvula and pharynx. These surgeries are quite invasive, however, and there are risks of adverse side effects. The most dangerous risk is that enough scar tissue could form within the throat as a result of the incisions to make the airway more narrow than it was prior to surgery, diminishing the airspace in the velopharynx. Scarring is an individual trait, so it is difficult for a surgeon to predict how much a person might be predisposed to scarring. Some patients have reported the development of severe sleep apnea as a result of damage to their airway caused by pharnygeal surgery. Currently, the American Medical Association does not approve of the use of lasers to perform operations on the pharnyx or uvula.
Radiofrequency ablation (RFA) is a relatively new surgical treatment for snoring. This treatment applies radiofrequency energy and heat (between 77°C to 85°C) to the soft tissue at the back of the throat, such as the soft palate and uvula, causing scarring of the tissue beneath the skin. After healing, this results in stiffening of the treated area. The procedure takes less than one hour, is usually performed on an outpatient basis, and usually requires several treatment sessions. Discomfort and pain is usually minimal. Radiofrequency ablation is frequently effective in reducing the severity of snoring, but, often does not completely eliminate snoring.
Bipolar radiofrequency ablation, a technique used for coblation tonsillectomy, is also used for the treatment of snoring.
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In 2006, estimates of the direct medical costs of allergic rhinitis in the US ranged from $1.16 billion to $4.5 billion, rising to $7.7 billion when indirect costs were included.
From: AHRQ
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