Snoring Treatment How well did you sleep last
night?
Have
you been told that you snore? Snoring is not only annoying to your bed
partner but also is bad for your health. It could deprive you and your
loved ones from proper sleep. A quiet, restful sleep is essential to good
health. Interrupted sleep associated with snoring may cause sleep apnea, a
condition where you can stop breathing for up to a minute, depriving you from
vital oxygen and may lead to many problems. Without the proper
amount of sleep you can:
Is there any danger associated with snoring?
As mentioned above, snoring is commonly a sign of a much more serious condition
known as sleep apnea, when individuals literally stop breathing during sleep.
Sleep apnea is the leading cause of heart attacks and strokes during sleep. Our
message is clear, “There are over 25 million people in the United States who
snore and may suffer from sleep apnea. The condition is ignored by the person
who is snoring because apnea (pause in breathing) happens when patients are
asleep,” according to Dr. Madani, chairman of the department of Oral and
Maxillofacial Surgery at Capital Health Medical Center and the director of the
Center for Corrective Surgery in Bala Cynwyd, Pennsylvania. In a chapter that
was published in the latest issue of the Clinics Of North America, Dr.
Madani has introduced several new techniques to treat snoring and mild sleep
apnea. “Our study of 5,600 patients showed that most snorers believe that they
are in fact better sleepers! The truth may be that they suffer from such a
severe case of sleep apnea that they are exhausted during the day and have
restless sleep at night. Over 70% of snoring bed partners spend more time apart
from their partners than together,” says Madani.
A procedure called LA-UPPP(Laser Assisted Uvulopalatopharyngoplasty) has been performed in our
center since 1992 on thousands of patients. The primary goal and effect of this
procedure is to reduce the intensity of snoring. On average, based on our
published data, the intensity of snoring is reduced up to 75%, significant
enough to help patients sleep with their bed partners and be successful in 95%
of cases.
This technique can
also help certain individuals with very mild obstructive sleep apnea. Every
patient is going to respond differently to these treatments and although
hundreds of patients were able to discontinue the use of their CPAP (a
sleep device that pumps air into your body through a nasal mask if you suffer
from sleep apnea) we do recommend continuation of the device even after
surgery. The LA-UPPP is not a cure for sleep apnea.
How is laser surgery for treatment of snoring is done?
After a careful analysis of your problem(s) and detail discussion of the
technique we use in our center, you are guided to a state-of-the-art examination
room. Your mouth, nose and throat are carefully examined using a high-tech
digital camera. You can actually see the problem(s) and clearly understand the
cause as well as limitations of any kind of surgery. Your questions are
carefully answered. During this period of evaluation, you must discuss with us
any medical problems you may have. That should include any recent colds or if
you take aspirin (or any other blood thinners). Of course, history of allergies
or other important medical information should be brought to our attention.
Once we reviewed
all the procedures, alternatives (which includes weight loss & CPAP, dental appliances as well as no
procedures at all) risks and complications then we are ready to proceed with
your care. If you are extremely overweight or have major signs of sleep apnea
we may recommend a sleep study prior to your treatment. All our patients are
given that option to rule out sleep apnea but once again we want you to know
that LA-UPPP is not a cure for sleep apnea.
After many years
of research, working with CO2 & Nd YAG laser, radiofrequency,
ultrasound, Bovie, EllmanTM, CoblationTM and SomnoplastyTM/SM as well as the surgical blade, we will determine what
technique works best for you. In general, we use the CO2 laser in our
present practice to trim the elongated
uvula and the part of the roof of the mouth adjacent to the uvula. If tonsillar
tissues are present, they will be treated with radiofrequency (CoblationTM, SomnoplastyTM/SM or EllmanTM) to make the tonsils smaller or even remove
a portion of the tonsils. This technique reduces pain and allows you to return
to your work or school the day after surgery.
Ninety of patients
are sedated (an IV line with a small amount of
medication given to relax you). It requires patients not to eat or drink for six hours prior to their treatment. If you are
considering having a procedure done on the day of your first visit, this is an
important consideration. A responsible driver must also accompany you.
Procedures are performed on site at our facility, so you don’t have to go to a
hospital and be admitted. Recovery is very fast from this type of
anesthesia.
On the average,
this procedure takes less than one hour but including pre-operative preparation;
you can expect to be our center for approximately 2 ½ hours. The procedure is
fairly simple done right in our state-of-the-art Bala Cynwyd
center. In general, most patients prefer to be asleep for this
procedure. The experience of the surgeon has a lot to do not only with how fast the procedure could be done but
how well and how precise. We have performed thousands of laser surgery cases
over the past ten years. With our changing technology, Dr. Madani has
significantly modified the procedure to be performed in a single visit.
LA-UPPP combined with Nasal
Radioablation: New
Technique Introduced By Dr. Madani For Treatment of Snoring
In search of a way
to treat snoring and sleep apnea, a variety of methods have been suggested and
are currently being used. Laser Assisted Uvulopalatoplasty (LAUP) is the
procedure being used by most surgeons. During this procedure CO2 laser is used
to trim the uvula. LAUP requires multiple visits and primarily involves
shortening of the uvula and only a minor portion of the soft palate. This
procedure has not proven to in any significant way correct sleep apnea.
Long-term results (over 7 years) have been associated with relapse.
Dr. Madani's
modification of Uvulopalatopharyngoplasty (UPPP) surgery involves using laser to
remove the uvula, shorten the soft palate and reduce the volume of the tonsils.
This procedure has been done by knife previously (standard UPPP performed since
early 80’s) and is well reported in the various medical journals. The older
technique however was done in the operating room and under general anesthesia.
Patients had to stay in the hospital in most cases for at least one night
following the surgery. The complications with the traditional (knife or
Electrocautery) were voice change and fluid reflux in 5-10% of cases (food and
fluids escaping through the nose when patients try to swallow).
UPPP assisted with
laser (see Journal Publication- published in the Oral & Maxillofacial Surgery Clinics Of North America,
August 2002)
includes removal of the uvula, ablation of a wide margin of the soft palate and
the tonsils (if applicable) in the office. In thousands of cases treated in our
center to date, only 0.1% of patients had small nasal reflux without continuous
draining of fluid out of nasal passages.
Dr. Madani’s
extensive studies were reported every year in the annual meetings of the American
Association of Oral and Maxillofacial Surgeons and the American College of Oral
and Maxillofacial Surgeons since 1998. These studies showed snoring
reduction by an average of 75% in intensity in over 90% of patients treated. There
were no cases of complete silence after surgery (no cases of silent apnea).
Patients who were suffering from sleep apnea and had to use the CPAP continue to
use it at a much lower pressure. No infection cases or airway obstruction were
ever seen in these patients. No voice changes were noted in the thousands of
cases treated by Dr. Madani.
Advantages of Single Step Laser Surgery
Fast: Procedures are performed in shortest period of time Painless: You are sedated and anesthetized during the procedure In office: Procedures are performed under monitored anesthesia in
the center Bleeding: Laser coagulates the tissues as it ablates, generally
bleeding is rare Fast recovery: You can return to work the following day after
surgery No hospitalization:Procedures are performed in
the office No general anesthesia: No operating room and nasal or oral
intubation needed
Breathing: You breathe by yourself during the procedure under anesthesia
which meanslower risk of respiratory complications Immediate return to work: We encourage all patients to return to
work the next day after surgery.