A Stiff Upper Palate Can Quiet Snoring
Mair tells WebMD that snoring patients who undergo the procedure are also tested for apnea. And further studies are underway to determine if injection snoreplasty also can treat obstructive apnea, he says.
The lengths to which snorers will go to be relieved of their nighttime noisemaking is liable to be determined by others in their household who can't take it anymore. And sometimes those others -- spouses or children -- can be adamant, though snorers themselves may be reluctant to undergo painful or expensive procedures, Mair says.
It was this that led Mair to find a simpler solution. And the story of how he came across injection snoreplasty using Sotradecol illustrates how there is nothing -- even in medicine -- that is new under the sun.
Mair had earlier developed a procedure to stiffen the palate by peeling off a layer of skin. The resulting scar causes the palate to stiffen -- less painful than UPPP, but still not a procedure snorers were eager to undergo. "You still hurt for about 10 days," Mair says.
Later, while traveling in England with his wife and perusing garden sales, Mair ran across an old medical journal from 1943 describing a small study using scarring agents to stiffen the palate and stop snoring.
Different areas of the palate were treated in that study and much smaller amounts of a substance no longer available were used, but the results were excellent, Mair says. "It remains unclear why the concept of injection [therapy] for the treatment of palatal flutter snoring did not develop further after this intriguing case series presentation," Mair writes in his report.
Mair then decided to search for a scarring agent to use as an injection. He selected Sotradecol because of its excellent safety record and documented effectiveness.
Sleep expert Mark Mahowald, MD, however, cautions that virtually every procedure for snoring has shown good results in the short-term, but disappointing results in the long-term.
"Before I would recommend any procedure to patients for snoring, I would want them to be aware that regardless of the short-term results, snoring is a progressive condition," Mahowald tells WebMD. "Even with the most aggressive surgical treatment, 50% of people are snoring again within four years." Mahowald is director of the Minnesota Regional Sleep Disorder Center at Hannepin County Medical and professor of neurology at the University of Minnesota School of Medicine.
Mahowald says some patients who have received UPPP or other aggressive surgeries have returned extremely angry because they had been told the procedure would cure snoring forever. A scarring procedure cannot be expected to have long-term success when even the most radical surgery is only effective in the short-term, he says.
"Patients should undertake any procedure with the full awareness that the short-term results may not hold up," he says.