Surgery

Although there are many  surgical procedures to treat snoring and related sleep disorders, the results are often disappointing.  Before heading down this path, be sure to test other remedies.  

Here are the major categories of surgery for snoring.

Open the airways by enlarging the throat

Uvulopalatopharyngoplasty (UPPP), also known as Palatopharyngoplasty enlarges the throat at the tonsillar level.  Usually the surgeon takes out your tonsils, and parts of your uvula and soft palate.  This  allows more room for airflow and leaves less vibratory tissue in your throat. 

Effectiveness:  Short-term, the procedure stops most people from snoring, but within a couple of years, research shows, only about half the patients undergoing this surgery say that the snoring has stopped or is markedly improved. 

Laser-assisted uvulopalatoplasty: a less expensive alternative to UPPP is laser-assisted uvulopalatoplasty (LAUP), which uses laser techniques to shorten the uvula and vaporize parts of your palate.  Whereas UPPP is performed under a general anesthetic, LAUP can be done under local anesthetic.  LAUP is indicated if you've already had your tonsils removed.

Effectiveness: One study of 741 patients found that snoring did return within 18-24 months in many patients, although it was less disturbing than before.  But only 55% of patients reported that their bed partner was satisfied with the outcome.  In 2001, an Israeli clinic reported that after a year their patients showed a significant decline in snoring improvement from 88% to 65%; snoring actually worsened in 12% of the cases, possibly because the laser-induced scarring made the back of the throat less flexible.

Cautery-assisted uvulopalatoplasty (CAUP): instead of a laser, some physicans use cautery equipment.  A heated wire or electrode is used to burn away all or part of the uvula.  A 2006 review found the effectiveness of UPPP, LAUP and CAUP procedures to be similar (more than 83%). Postoperative pain was mostly seen in LAUP and UPPP cases. The CAUP procedure was easy and the least painful.

Stiffening the tissue in the throat and soft palate

Snoring is the vibration of those flabby tissues in your throat and palate.  Some surgical treatments seek to reduce snoring by hardening your tissues.

Cautery-assisted palatal stiffening operation (CAPSO) -- in which the surgeon uses electrocautery equipment to remove part of the soft palate -- is a cost-effective procedure conducted on an outpatient basis.

Effectiveness: One study of 206 patients showed a 92% short-term success rate, and 77% percent success at 12 months.

Somnoplasty and Coblation, described more fully elsewhere on this web site, also achieves palatal stiffening using radiofrequency energy to scar the inner palate. This is a more recent procedure, with long terms results still unclear.  It's more expensive than CAPSO.

And most recently, Restore Medical has introduced the Pillar procedure, using polyester inserts to stiffen the palate.

More invasive surgery

Additional surgical remedies available to those who snore include solutions for shrinking part of the tongue or repositioning your jaw (typically moving your lower jaw forward).

For those whose snoring is due to abnormalities in your nose or upper airways, nasal reconstructive surgery to open obstructed nasal passages can also aid in the relief of snoring and sleep apnea.  Read more about nasal surgery.

And finally, tracheostomy, a direct opening into the windpipe, bypasses the obstruction and relieves snoring and sleep apnea completely. 

By the time you've reach the stage of opting for tracheostomy, you are long past the stage where this web site is going to be of any value to you....

This page owes much to an article by Philip D. Littlefield in Ear Nose and Throat Journal, November 1999, Snoring Surgery: Which one is best for you? 

Snoring
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