Somnoplasty for Obstructive Sleep Apnea and Snoring

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Obstructive Sleep ApneaSA is a common condition that results in intermittent blockages of airflow while sleeping. The obstructive events can cause partial or complete blockages of airflow that result in decreased oxygen levels.

Patients often report feeling tired, not feeling well rested in the morning, having morning headaches, waking up with a dry mouth, and a multitude of other symptoms. Untreated OSA can cause problems with many medical conditions including, but not limited to high blood pressure, high cholesterol, heart disease, diabetes, and depression.

What is Somnoplasty?

The Somnoplasty procedure for obstructive sleep apnea (OSA) and snoring is performed under local anesthesia by shrinking soft tissue in the upper airway including the base of the tongue, soft palate, and nasal turbinates. Somnoplasty uses radiofrequency (RF) energy to provide a minimally invasive and less painful treatment of upper airway obstructions under local anesthesia.

During Somnoplasty, we use an automated RF control unit with temperature monitoring capabilities and a single-use, disposable surgical hand piece that delivers controlled thermal energy into targeted areas to reduce tissue volume and stiffen soft tissue.

How does Somnoplasty work?

How Somnoplasty WorksThe Somnoplasty procedure for OSA generates heat at approximately 85° C (185° F) to create finely controlled coagulative lesions at precise locations within the upper airway.  An insulating sleeve at the base of the needle electrode is intended to protect the surface of the tissue from thermal damage, thereby minimizing post-operative discomfort. The lesions created by the procedure are naturally resorbed in approximately three to eight weeks, reducing excess tissue volume and opening the airway.

Typically, the Somnoplasty procedure for obstructive sleep apnea takes 30 to 45 minutes, with only five to 10 minutes required for RF energy delivery. The procedure is performed in our clinic and patients can return to their normal activities the following day. Typically, more than one treatment is necessary to achieve optimal results.

What should I expect during the Somnoplasty procedure?

Somnoplasty is performed under local anesthesia in an outpatient setting. In contrast to conventional surgery, during somnoplasty we are able to protect the delicate surface of the tongue, control the delivery of energy, and maintain a constant, low temperature. These features result in far less post-operative discomfort. While people undergoing traditional surgery can suffer significant pain, individuals undergoing Somnoplasty usually experience only mild swelling and discomfort.

How effective is the Somnoplasty System in the treatment of OSA?

Clinical results have shown that Somnoplasty effectively treats obstructive sleep apnea by shrinking the base of tongue — the most difficult source of obstruction to treat — in moderately and severely affected patients. Sophisticated testing and analysis following treatment with Somnoplasty indicated that patients experienced an average of 17 percent and as much as a 35 percent reduction in tongue tissue volume, a range that is comparable to conventional surgical techniques.

Who is a candidate for the Somnoplasty procedure for OSA?

Somnoplasty can be an effective treatment for people with mild, moderate, or severe OSA due to obstruction at the base of the tongue, soft palate and nasal turbinates. If you believe that you or a family member may have OSA, it is very important to be evaluated by a physician who can confirm the presence of obstructive sleep apnea (through a sleep study) and identify the possible sites of airway obstruction. Upon evaluation, we can determine if Somnoplasty may be an appropriate therapy.

What are the different tissues involved in Somnoplasty?

Snoring is a result of several types of obstruction in the nasal passage. For example, when snoring is a result of excessive relaxation and vibration of the tissues at the back of the nose or throat, Somnoplasty is done at the level of the soft palate by shrinking and tightening the tissues of this area. If snoring is caused by enlarged inferior turbinates, then somnoplasty may be used to treat chronic nasal congestion and the turbinates are the prime focus of the operation.

This significantly reduces the volume of the obstructing turbinates. Somnoplasty can also be used to treat sleep apnea – a condition where breathing stops temporarily while asleep, due to severe blockage in the air passage at the level of the base of tongue. Here the tissues involved are those at the back of the mouth, throat and the nose. The tissues located in the upper air passage are shrunk and the airway cleared.

How does Somnoplasty work?

Essentially, Somnoplasty procedure uses low levels of radiofrequency thermal energy on the relevant sections of the uvula or the soft palate with the aim of freeing the air passage of any obstruction. Depending on the nature of the obstruction, the tongue, throat or the soft palate could be pierced with a sterilized, single-use disposable needle, called the electrode. This is further connected to a low-intensity radiofrequency heat generator. The concerned tissues are heated with the help of the electrode, to a temperature between 158 and 176 degrees within a span of half an hour. The heat energy creates very small burn areas in the sections where it has been applied. However, over 4 to 8 weeks these get re-absorbed by the body.

This in effect, reduces the volume of tissues, as well as renders them stiff, so that snoring is substantially reduced or eliminated. While the burning causes the inner tissues attached to the concerned obstructive muscle to shrink, the tissues located on the outside (and may contain taste buds, etc) are left untouched. It takes about 5 to 10 minutes for radiofrequency energy delivery and 30 to 45 minutes to perform the surgery. Performed under local anesthesia in an outpatient clinic of an ENT surgeon, the procedure takes about 30 minutes for completion.

What happens after somnoplasty surgery?

Here are some of the after-effects of the somnoplasty procedure:

  • You might experience some swelling and discomfort.
  • Some patients have reported pain after the surgery but the pain usually lasts only for a few hours. Post-surgical pain can be treated by effective over the counter pain medications.
  • The possible complications after somnoplasty surgery are similar to any outpatient surgery and may include bleeding, infection, inflammation and blood clots.
  • At times, somnoplasty procedure does not yield the desired results. In such cases, a second procedure is usually performed.
  • If your surgery is successful, you should start to see a reduction in your snoring and improved sleep in one to two weeks after the surgery, and will continue to reduce for several months after the operation.

How long does it take for Somnoplasty to be completed?

This simple and non-invasive surgical intervention uses only local anesthesia and is done at the doctors’ office. While one session of somnoplasty may take less than 30 minutes, you may need more than one session, depending on the severity of snoring, to get the desired results. The second session is usually arranged after 6 to 8 weeks of the first procedure.

Will Somnoplasty cause me any pain?

No matter what kind of surgery you opt for, it is bound to involve some amount of pain and risks. Unlike other surgical procedures though, somnoplasty is relatively less painful, though there are chances of some minor swelling and an uncomfortable feeling immediately after the procedure.