Surgery to cure Snoring – Before the days of Laser

 

Snoring, in addition to its obvious social consequences is clearly associated with significant pathophysiological changes that may be detrimental to the patient.

Uvulopalatopharyngoplasty (UPPP) was done routinely done to cure snoring in 1980s by myself i.e., before the days of Laser. UPPP was the effective surgical treatment those days. But by the advent of Laser surgery this procedure is not routinely done these days.

 

The following article published in the Journal of Bahrain Medical Society shows the details of method and results involved in the procedure.

-Surgical Treatment of Snoring by Uvulopalatopharyngoplasty (UPPP). The Journal of Bahrain Medical Society K O Paulose and S. Al-Khalifa April 1990, Vol. 2, No.1, pp. 17-20)

 

 

 

Snoring

Is the sound produced by vibration of the relaxed tissues of the soft palate, oropharynx and hypopharynx during sleep. While sleeping in supine position air turbulence is produced in this narrow space causing the sound of snoring.

Many patients don\’t seek medical advice until compelled to do so by their spouse or relative. While the snorers sleep undisturbed the sleepless companion always suffers and may be the victim of major social problem.

At least 40 percent of population snore occasionally, 20-30 percent are habitual snorers.. According to the level of snoring, and the loudness of the offending noises, the snorers can be classified into simple chronic snorers, and  heroic thunderous snorers. The latter are heard 3-4 rooms away or the next door neighbor.

 

Anti snoring Devices

 

There is no shortage of alleged cures for snoring, among the anti snoring gadgets available on the market are nose clip, dental splints, nasal dilator, electric neck collar, snoring alarm, oily nasal sprays, earplugs are popular.

There have been attempts to cure snoring by keeping a pencil between teeth, placing a tennis ball on the back stitched to the nightdress to keep the patient sleeping on the side.

 

CPAP

 

Use of Continuous positive airway pressure CPAP is cumbersome.

 

Surgical means

 

Somnoplasty, injecting sclerosants into the soft palate, mandibular osteotomies, hyoid expansion, and tracheotomy are the extremes.

 

 

 

 

UPPP

Fujita et al in 1981 introduced the operation of UPPP for OSA. This proved to be highly effective as it abolished or improved uncomplicated snoring in 90 percent patients.

This involved excision of tonsils, terminal soft palate and uvula under general anesthesia. The mucosal margins are then sutured by 3 0 vicryl.

 

Results

 

The results of the procedure were very good indeed but the post operative pain was immense. The other rare complications included nasal regurgitation to liquids, nasopharyngeal stenosis and bleeding.But gone are those “painful “days.

 

 

 

Advent of Laser

 

By mid 90s I started doing UPPP by laser; we called it LAUP-Laser Assisted Uvulopalatoplasty.The success rate and patients compliance increased by using laser. Looking back in 20 years doing anti snoring surgery in many hundreds of patients, I feel content. Thanks to LASER