When you breathe normally, air makes its way to your lungs by passing through your mouth, over your tongue, and past your soft palate, uvula, and tonsils.Your soft palate is the area at the back of the roof of your mouth. Your uvula is the dangling structure visible at the back of your mouth, or pharynx.
When you're awake, the muscles in the back of your throat tighten in order to hold these structures in place and prevent them from vibrating or collapsing across your airway. When you sleep, your muscles are more relaxed, allowing for the tissue surrounding your airway to take up more space and to possibly obstruct or affect your breathing. It can cause your soft palate and uvula to vibrate as you breathe, causing the distinct sound of snoring. Snoring may also be caused by vibration of the base of your tongue or tissue further down your airway. Somnoplasty is a unique surgical procedure that helps reduce habitual snoring by modifying the tissues of the soft palate and uvula.
What is Somnoplasty?
This surgical method, which is also called radiofrequency tissue reduction or radiofrequency tissue ablation, helps to reduce habitual snoring by stiffening or removing tissues of your soft palate and uvula. Unlike a laser or other approaches, it uses extremely low radiofrequency heat energy levels to create a finely controlled and localized burn area under the lining (mucosa) of your soft palate tissue.
Your body eventually resorbs and eliminates these burn areas naturally, shrinking the volume of tissue and stiffening the tissue that is left, typically reducing symptoms of snoring. Your surgeon will perform this procedure under a local anesthesia. It usually takes about 30 minutes and is an outpatient procedure.
Uses of Somnoplasty
This Food and Drug Administration (FDA) approved medical treatment is used to treat multiple conditions, including habitual snoring and chronic nasal obstruction. Since it reduces the tissue volume in your airway, it may also improve symptoms of Obstructive Sleep Apnea (OSA) but is not indicated for singular treatment of OSA.
It's important that you have a sleep physician involved during your evaluation with your ENT doctor for snoring. It is important to be evaluated for OSA before undergoing surgical treatment for symptoms of snoring.
OSA is a condition associated with other medical problems including heart disease, risk of stroke, daytime sleepiness, and increased risk of motor vehicle accident. Snoring is a hallmark of OSA but that doesn't mean you have OSA if you snore. A sleep physician can help you to rule out OSA or to assess your current severity with an overnight sleep study.
What the Somnoplasty Procedure Entails
If it has been recommended for you to undergo somnoplasty for your snoring or sleep apnea, you should know what it entails and what is required of you before, during and after the procedure.
Before the Procedure
Don't take any aspirin or products that contain aspirin within 10 days of your somnoplasty procedure date. If you aren't sure of the contents of a certain medication, give your pharmacist or doctor a quick call. An acceptable pain reliever, if you need one, is acetaminophen (Tylenol). Don't take ibuprofen (Nuprin, Advil, Motrin) before consulting with your doctor first. This goes for all nonsteroidal anti-inflammatory drugs.
You can eat a light meal before your scheduled procedure. If you smoke, it's a good idea to try to stop or at least reduce the amount of cigarettes. This helps in reducing post-operative bleeding and coughing.
Your doctor will give you an oral spray to anesthetize the throat, followed by a few small injections of local anesthetic to fully numb the area to be worked on. You may experience slight discomfort with the injections.
During the Procedure
During your procedure, you'll be asked to sit upright and will be awake throughout. Before your doctor starts the procedure, they'll discuss the process and equipment to be used.
To begin the somnoplasty procedure, your doctor will connect the Somnus device to a radio frequency generator. The device has a small electrode at the end which the doctor inserts into your soft palate tissue to deliver energy to three different areas. Each area requires a couple minutes of treatment.
A portion of the electrode is insulated in order to protect your delicate surface tissue. The surgeon heats the tissue in a limited site around the electrode through controlled delivery of radiofrequency energy.
Most patients find the procedure to be surprisingly comfortable.
After the Procedure
You are able to go home that day once you feel comfortable, most patients are able to drive themselves safely. You can expect some discomfort after the procedure as you heal. Many patients report a sense of fullness at the back of their throat. You could have a sore throat for a few days and any snoring may initially be worse due to local inflammation of the treated tissue. You can take tylenol or ibuprofen to help with the pain and swelling. It's helpful to keep your head elevated above your heart when sleeping to avoid increased edema and swelling. You can also try a throat lozenge or anesthetizing spray to soothe your throat. Eating and drinking is okay once the anesthesia has worn off. Advance your diet as tolerated, there are no specific restrictions.
Improvement in symptoms typically starts to become noticeable after 1 to 2 weeks and may continue for several months. It is a good idea to complete a new sleep study for reassessment of snoring, OSA severity, or other breathing disorder. You should return for check up with your surgeon's office within 7 - 10 days of your procedure.
You should notify your doctor if you notice extreme difficulty swallowing, breathing, or sudden bleeding from the procedural site.
There are a few other complications, or possible outcomes, of which you should be aware prior to undergoing somnoplasty:
1. Failure to eliminate or resolve snoring. The majority of surgeons feel that approximately 80 percent of patients who undergo somnoplasty see a substantial reduction in their snoring for at least one years. Others notice reduced levels of snoring to the point that their sleep partners are not reporting it as offensive.
2. Failure to cure OSA or apnea or pathological sleep conditions that are medical problems with serious complications. Somnoplasty, at this time, isn't a cure for these conditions.
3. A change in voice, nasal regurgitation or velopharyngeal insufficiency. This can result in liquids flowing into your nasal cavity while swallowing, this is a rare complication.
4. Electrical or thermal injury to the mucous membranes of your uvula, soft palate or mouth. This can result in tissue loss by burning, an expected outcome of this procedure that may be outside of the controlled area.
5. Recurrence of your snoring after a while (typically greater than one year) could occur. It's believed this happens when your tissues stretch out over time.
You may need to have the somnoplasty procedure repeated to fully resolve your symptoms.
Keep in mind that, as with any surgery, there are potential complications and risks that you must weigh against the potential benefits. Please speak with your doctor about these prior to surgery.
Success Rate of Somnoplasty
The somnoplasty success rate is fairly good. Although your snoring may get worse immediately following your procedure due to local swelling of your treated tissues, you should start seeing improvement beginning in your first couple of weeks. Your improvement may continue for up to several months.
According to a study of 29 participants with habitual or obstructive snoring, radiofrequency volumetric tissue reduction (RFVTR) of the soft palate is considered a successful treatment for mild OSA. Around 10 weeks after the procedure, 24 of the 29 participants reported a reduction in their snoring after just one treatment. Out of these 29 participants, 8 were treated with RFVTR exclusively and results showed that 5 out of 8 showed a reduction in snoring symptoms.
If you'd like to learn more about your treatment options for snoring and sleep apnea, call Sound Sleep Health in Seattle today at (425) 636-2400.