|
Following the initial success of radiofrequency to treat snoring by
application of heat to reduce the tissue volume, creating submucosal scar
and hence diminishing palatal vibration another innovative technique was
introduced using polyester suture type material to achieve similar results.
Pillar Implant (Restore Medical, Incorporated St. Paul, MN) received FDA
clearance for snoring and obstructive sleep apnea in 2004. |
|
The above illustration
demonstrates the use of Pillar palatal Implant. (©Mansoor Madani DMD and
with permission from the Atlas of Oral and Maxillofacial Surgery Clinics of
North America)
Restore Medical Inc. has developed the Pillar TM
Palatal Implant System, an alternative solution for snoring treatment. The
implant consists of three pieces of polyester yarn less than an inch long.
Designed to be permanent, they are inserted into the soft palate on the roof
of the mouth. They prompt the tissue to stiffen and in turn reduce the
"flutter" which is the main culprit in the snoring sound. The implant
inserts are carefully designed to provide these effects without adversely
affecting normal palate function. |
|
There is no need for repeated procedures, extensive
operating room equipments, expensive laser systems
of RF generators. There is no heating, burning or removing of tissues
so it minimizes swelling and post-procedure
discomfort. In case of any problems, it can easily
be retrieved providing patients and their doctor’s flexibility for other
treatment options in the future. Most patients can resume normal activities
and diet shortly after this minimally invasive procedure.
Procedures are generally performed in one visit in an outpatient setting
under local anesthesia. The effectiveness of each procedure depends on
patient selection, the surgeons’ experience not only with this system but
with other surgical procedures such as palatal Radioablation. It also relies
on patient as well as the bed-partners expectation. Just like any other
surgical procedure, the long term results have not
been very stable in our limited experience. (unlike laser surgery or
Radioablation procedures, and because of high failure ratio of palatal
Radioablation we have been very conservative in utilizing this device, and
have consulted with many other professionals regarding their experience
using this device as well. A complete report could be found in the
Atlas of Oral & Maxillofacial Surgery Clinic of North America.
We
will evaluate interested patients then based on the anatomy of their airway
may recommend this procedure. Our recommendations have been very similar to
other palatal stiffening procedures such as Radioablation.
Pillar Implants in selected cases with short uvula, hyperplastic soft palate
and BMI of less than 25 with minimal indication of obstructive sleep apnea
has been an effective
method of treatment in reducing the snoring sound
intensity. It is imperative that surgical cases are selected meticulously
for this procedure since the long term results, in 45% of cases, in the
author’s experience had relapse of their snoring problem and the
effectiveness of this procedure for correcting the more serious cases of
obstructive sleep apnea is highly questionable.
|
