Does Snoring Surgery Work?

Around 30-45% of adults regularly snore. When we breathe the air passes through the throat on its way to the lungs. It must pass the tongue, the soft palate, the uvula, and the tonsils.

While we are awake muscles in the back of the throat hold these structures in place, but when we sleep the muscles relax and as we attempt to breathe passage of air the constricted passages may cause a vibration– which makes the snoring sound.

Children, and less commonly adults, with enlarged tonsils and adenoids, may also snore. Patients who snore need a comprehensive sleep evaluation to determine the best treatment option.

There are many treatments available such as snoring aids – and surgery is the last resort for persistent snorers.  Most people turn to the SnoreRx or the Zyppah for treatment.

The results of surgery depend upon several factors.

• The type of operation.
• The skill of the surgeon
• The shape of the patient’s neck and jaw
• Whether the patient is overweight or obese
• Smoking

The Types of Snoring Surgeries

Tonsillectomy and adenoidectomy

Tonsils are lumps of lymphoid tissue on either side of the throat. Adenoids are similar but at the back of the nose. When they grow large, they can obstruct the airway, resulting in snoring and a poor quality of sleep.

Removal of the tonsils and adenoids, under general anesthesia, will stop the snoring. The patient may have a sore throat for a couple of weeks after the operation, and there may be some bleeding, often around one week later – but this is rarely severe.

Uvulopalatopharyngoplasty (UPPP)

This operation involves the surgical removal of the uvula and pharyngeal arches, partial removal of the soft palate and sometimes the tonsils, under general anesthetic. (Uvulo – palato – pharyngo – plasty)

Postoperative pain can be severe, and long-term complications can occur. These complications include voice changes, partial loss of taste sensation, a dry palate and nasopharageal regurgitation.

Laser-Assisted Uvuloplasty (LAUP)

The surgeon will do this under local or general anesthetic. It is a safer, usually less painful, and a more economical alternative to UPPP. The free edges of the soft palate and uvula are vaporized using a laser. Repeat treatments may be needed, and although it is said to be less painful than UPPP, postoperative pain can still be severe, making patients unwilling to submit to further treatments. After two years, only 55% of patients were happy with the outcome of these two operations.

Palatial Stiffening procedures

1. Pillar procedure – Palatial Implants can be inserted into the soft palate under local anesthesia as an outpatient procedure. This procedure stiffens the palate and the scarring which occurs further stiffens the palate. The result is less vibration which reduces the snoring.

It’s easy to do, is not very uncomfortable and patients recover quickly. However. The implants are expensive.

1. Injection Snoreplasty is also done under local anesthetic as an outpatient. A chemical, usually Sodium tetradecyl sulfate, is injected into the soft palate which causes a natural body reaction. The soft palate becomes inflamed and scar tissue forms which is rigid and stiffens the soft palate, thereby decreasing the vibrations that caused snoring.

Although it is more uncomfortable than the implants, it is also cheaper. However, some patients require repeat injections.

Somnoplasty (radio frequency)

Somnoplasty is another method used to stiffen the soft tissues. It uses very low levels of radiofrequency heat energy to make small burns in the soft palate. After a while, these burnt areas are reabsorbed by the body, which shrinks the tissues and stiffens them. This shrinkage and stiffening reduces snoring.

The procedure is done in outpatients under local anesthetic and takes around 30 minutes. While the success rate is around 80% reduction in snoring for at least one year, that still means that 20% have less satisfactory results.

Complications are rare – but they do occur from time to time.

A very rare complication is nasal regurgitation. This regurgitation is when liquids may flow upwards into the nasal cavity instead of down into the esophagus. Occasionally the operation leads to prolonged pain, bleeding and poor healing. Added to which, recurrence of snoring as the tissues stretch may occur, needing further revision or even more aggressive surgery. Both the cost and the degree of discomfort lies between implants and injections.

Note that snoring will be worse immediately after operations because of swelling of the tissues. You will also have a sore throat for several days. You will need a review 7-10 days after the operation. Other possible complications include postoperative infections and impaired hearing.

Nasal Surgery

Congestion in the nose can cause snoring, and there are several causes. These include allergies, polyps, turbinate hypertrophy, and deviation of the septum. While the allergies can be treated with sprays and medication, the structural problems require surgery.

Radiofrequency can be used to reduce the size of the turbinates, on each side of the nose. This reduction is done under local anesthetic in the office. Removal of polyps and correcting the deviated septum are usually done in the operating room under general anesthetic.

For the right patients, these nasal treatments are effective and have few side effects.

How you can help

Before surgery, you can help to prevent bleeding by stopping taking aspirin for the prior ten days and check with your doctor about any other medications.

Coughing will be painful, and more likely if you smoke.

Postop Expectations

After the operation, there will be pain. There is no guarantee of success in the long term, and operations cannot be reversed. It is essential to have a full work up before the operation, as there are other causes for snoring which the operations do not address. Treatment is less successful for certain individuals. They include the obese, smokers, people who drink a lot of alcohol, people who still have their tonsils and those who simply do not have the right shape of jaw. However, at least in the short term, there is around an 80% satisfactory result.