Definition and Overview

A pillar procedure is an FDA-approved sleep apnea and snoring surgery that involves implanting three specifically designed rods in the soft palate to reduce vibrations that cause snoring, a condition that affects 90 million men and women in the United States alone.

Snoring can be a symptom of a serious underlying condition known as obstructive sleep apnea (OSA), which is a life-threatening sleeping disorder that involves intermittent breathing. This means a person stops breathing for up to 20 seconds several times during the night.

Aside from a pillar procedure, there are also other available treatments for snoring and OSA. These include continuous positive airway pressure (CPAP), oral breathing appliances like nasal dilators and surgery like uvulopalatopharyngoplasty (UPPP), which involves removing excess tissues to widen the air’s passageway.

Who Should Undergo and Expected Results

A pillar procedure is recommended for people who have mild to moderate case of sleep apnoea. It is not recommended for those who are severely obese or whose snoring is caused by blockages in the throat.

As a sleep apnea and snoring surgery, the pillar procedure is only considered when other conventional treatments like CPAP failed to correct the condition.

Before the procedure is even considered, it is a must that the patient has been clinically diagnosed with OSA, especially since there are other types of sleep apnea, such as central sleep apnea, that is caused by the inability of the brain to tell the muscles that regulate breathing to work properly.

Diagnosing OSA involves a comprehensive sleep study in a center or lab where the patient is monitored for at least a day or two.

As for the expected results, patients who undergo the pillar procedure will notice a significant improvement in their sleep within a few weeks to 3 months following the sleep apnea and snoring surgery.

How Does the Procedure Work?

The pillar procedure uses specially designed implants that are made from polyester, which is the same material used in several implantable appliances or devices for many years. Each of these implants measures no more than 18 millimeters with an outside diameter of 2 millimeters.

The implants are placed on the soft palate, which plays a large role in the breathing process while a person is asleep. It forms part of the mouth’s palate, which is found at the roof of the mouth near the hard palate.

Prior to the sleep apnea and snoring surgery, the surgeon—who can be an otolaryngologist, a doctor who specialises in ears, nose, and throat)—reviews the patient’s medical records to ensure he is eligible for the procedure and can greatly benefit from it.

The procedure is conducted in an outpatient setting and can be performed either under local or general anaesthesia. The implants are placed into the soft palate using their individual delivery tool. The procedure takes only 20 minutes and one office visit. The patient is allowed to go home once the effects of the anaesthesia have worn off. To reduce the risk of infection, the patient will be provided with antibiotics.

Possible Risks and Complications

Patients may feel some discomfort and pain during and after the procedure. In some cases, the implants protrude out of the soft palate tissue, getting in the way of swallowing and eating.

Because the pillar procedure is minimally invasive, recovery is very quick. The patient can go back to his regular activities within the day, although it is best if someone drives him back at home due to the possible aftereffects of anaesthesia.

References:

  • Choi JH, et al. Efficacy of the Pillar implant in the treatment of snoring and mild-to-moderate obstructive sleep apnea: A meta-analysis. The Laryngoscope. 2013;123:269.

  • What is sleep apnea? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/sleepapnea/. Accessed Dec. 16, 2013.

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