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Tuesday, March 2, 2010

Surgery to Stop Snoring

Rose knows when she was married more times than not her and her husband had to sleep in separate crypts let alone the same double-wide coffin due to his loud snoring. This is a problem with many couples today…they sleep in different rooms because one is a habitual snorer. While you might consider surgery to stop snoring as the extreme, for most that have a chronic snoring problem, it is no surprise that surgery sounds like a good solution. Chronic snoring can be a ‘side effect’ to another serious medical issue and you should talk to your doctor before your health worsens.

If we snore we hate to admit to it and even if we do admit to it, we don’t think it’s serious enough to talk to a doctor. We hate doctors. They cost us time and money. So, we spend our money on stop snoring aides such as; nasal strips, chin straps, tongue guards or an at-home method, like a shirt that doesn’t allow you to turn on your back…. Lol. If, you have a sleep routine it is hard enough to remember to do everything, let alone put on an uncomfortable snoring aide. You’re going to have to keep a sleep routine check list!

Surgery to stop snoring is definitely a way to reduce the number of things you need to do to get ready for bed. Like any surgery it is not only expensive but there are possible risks involved such as infection and scar tissue build-up. Scar tissue could make you snoring worse and might even close your breathing air passage. Are you ready to accept the risks? Have you consulted with an experienced surgeon? Have you talked to your insurance company to see if the surgery is covered? Most insurance companies feel that surgery for snoring is elective unless you are a chronic snorer and an otolaryngologist (ear, nose and throat specialist) finds it medically necessary. You may need to have a sleep study done to determine the cause of your snoring and depending on the diagnosis will depend on which specialist you will need to see for proper treatment. Remember, I said before snoring is usually a result of another health problem.

You may have enlarged tonsils and adenoids or excess uvula tissue, which constrict your air passage. A UPPP or uvulopalatoharyngoplasty will remove the excess tissue which usually decreases snoring by widening the airway. You will stay in the hospital a day or two and expect full recovery to take at least three weeks. During recovery, swallowing will be difficult and you will have to eat a liquid diet for a bit. UPPP is effective in decreasing snoring, but over the long period of time has cured only 46% to 73% of the cases. You may experience a change in your voice. A risk of infection and a condition called ‘nasal reflux’ may result. The average cost is between $10,000 and $12,000.

A LAUP or laser-assisted uvulopalatoplasty is a modified UPPP as the surgeon will use a laser instead of a scalpel to shorten the soft palate and cut away the uvula. Because the laser is so hot it cauterizes the wound as it cuts. When the wound heals and a scar is formed, the new tissue is smaller and stiffer than it was before and therefore decreasing your ability to snore. The LAUP procedure may involve two to five outpatient sessions spaced from four to six weeks apart and each lasting for about 30 minutes. This procedure isn’t recommended for sleep apnea patients or light snorers, but those with chronic snoring and those that snore loud and disruptive. Note: LUAP may alter your voice. Average cost is about $1500 to $2000 per procedure.

Cautery-assisted palatal stiffening operation or CAPSO uses heat to burn or cauterize tissues of the palate. When the palate heals, the resulting scar tissue will be stiffer and less likely to cause snoring. Patients experience postoperative pain, but not as much as UPPP or LAUP procedures. This surgery is relatively inexpensive as it cost roughly $150.00 per treatment and is done on an out-patient basis. Risks are minimal compared to the other procedures. Note: this is an experimental surgery and hasn’t been fully evaluated. Researchers need to conduct more studies on CAPSO before we recommend it.

If your snoring is a result of a blockage in the nose, nasal surgery will remove any obstructions or correct a deviated septum. A deviated septum is one of the most common causes of snoring and can often be slightly corrected without the use of invasive surgery. The septum is, in essence, the flap of skin and cartilage that divides your two nostrils. Because the majority of the septum lies within your nasal cavity and cannot be easily seen, many people would never know they had a deviated septum if it wasn't for the snoring. Many patients who receive septum surgery for medical reasons elect to get a full rhinoplasty while they are under the knife. Keep in mind, however, that many insurance companies will cover septum surgery for the purpose of reducing snoring, while few, if any, will cover a rhinoplasty for cosmetic reasons. A rhinoplasty costs vary depending on surgeon and the city performed. In Indianapolis, it will cost $3750 - $5500.

If you suffer from OSA (obstructive sleep apnea) your doctor may suggest genioglossus and hyoid advancement which prevents the collapse of the lower throat by pulling the tongue muscles forward. The genioglossus is a major tongue muscle that advances, retracts and depresses the tongue. The hyoid is a u-shaped bone at the base of the tongue that supports the tongue muscles. The tongue suspension procedure keeps the tongue from falling back over the airway during sleep. A small screw is inserted into the lower jawbone and stitches below the tongue. This procedure is usually performed along with others and is potentially reversible. If this operation is done in the hospital it can run as high as $8000 on an out-patient basis $500.

Somnoplasty also known as radio frequency tissue ablation (RFTA) uses a needle electrode that emits energy to shrink excess tissue. The tissue is reabsorbed by the body thus shrinking the soft tissue of the palate which can help minimize snoring. This procedure is performed under a local anesthesia as an outpatient surgery and designed to lessen bleeding and postoperative pain. Pain can be controlled by over-the-counter drugs like Tylenol. More than one treatment is required and the final cost could run as high as $2500. Radio frequency procedures are still under study therefore, there are no statistics on its effectiveness. Many hospitals may not have the equipment to perform a somnoplasty. An even newer type of procedure using radiofrequency energy is called coblation channeling. Unlike somnoplasty and other procedures that shrink tissue, coblation channeling both shrinks and removes excess tissue.

Snoreplasty or injection snoreplasty is also a new procedure where a hardening agent is injected into the soft palate to promote scarring and stiffening of the tissue. Injection snoreplasty is performed on an outpatient basis under local anesthesia. After numbing the upper palate with topical anesthetic, the hardening agent is injected just under the skin on the top of the mouth in front of the uvula (upper palate), creating a small blister. Within a couple of days the blister hardens, forms scar tissue, and pulls the floppy uvula forward to eliminate snoring. This procedure is less painful and less expensive than other options running around $700 - $1,000 for the two required treatments. Tylenol and throat lozenges or spray are suggested for pain management. Patients can return to work the next day. Though snoring may continue for a few days, it should eventually lessen. A post-procedure sleep test may be administered to fully evaluate the effects of the procedure.

Forty-five percent of normal adults snore at least occasionally, and 25 percent are habitual snorers. Thirty percent of adults over age 30 are snorers. By middle age, that number reaches 40 percent. Clearly, snoring is a dilemma affecting spouses, family members and sometimes neighbors. If your spouse is sleeping in the other room because he/she snores and other snore remedies haven’t worked, you may want to consider surgery to stop snoring. So STOP THE SNORING MADNESS and get back into bed with the one you love.
Good Day,
Rose Sheepskill


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Evaluating how and when you snore will help you pinpoint whether the cause of your snoring is within your control or not. The good news is that no matter how and when you snore, there are solutions to making your snoring better.

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