How safe and effective is palatal foreshortening and stiffening in reducing snoring severity in non-obstructive sleep apnea (non-OSA) patients?
Bottom Line: Post-treatment improvements in visual analogue scale (VAS) scores, daytime sleepiness, and quality of life were observed.
Explore This IssueMarch 2020
Background: Non-surgical snoring treatment to open the airway for non-OSA patients often focuses on palate stiffening through injection sclerotherapy, laser therapy, cautery procedures, radiofrequency ablation, and palatal implants. An office-based procedure to stiffen and foreshorten the palate may improve success rates and reduce morbidity.
Study design: Open-label, prospective, single-arm cohort study of 52 adults with chronic disruptive snoring treated using the Elevo kit (Zelegent, Inc., Irvine, Calif.) and the Elevoplasty procedure.
Setting: Eight sites in the United States.
Synopsis: Prior to treatment, the mean VAS score for snoring severity as assessed by the bed/sleep partner was 7.81 ± 1.59. Thirty days post-procedure, the VAS score decreased significantly to 5.77 ± 2.35; at 90 days it decreased to 4.48 ± 1.81; and at 180 days it decreased to 5.40 ± 2.28. The mean within-subject Epworth Sleepiness Scale at baseline was 6.63 ± 4.00. It decreased to 5.38 + 3.21 at 30 days post-procedure and was maintained at 90 and 180 days. The mean Pittsburgh Sleep Quality Index score at baseline was 7.04 ± 3.53. It decreased at 30 days post-procedure to 5.51 ± 2.58 (P < .001) and was maintained at 90 and 180 days. There was some improvement, but no significance, in percentage of snoring event types or average event loudness ratio. There were no reported adverse events, although two subjects reported being able to palpate an implant with their tongues after discharge. Peak post-procedure pain VAS on the evening of the procedure was 3.85 ± 2.69 and had decreased 24 hours later. Three out of 52 reported using an opioid for post-procedure pain control.
Citation: Friedman M, Gillespie MB, Shabdiz FA, et al. A new office-based procedure for treatment of snoring: The S.I.Le.N.C.E. study. Laryngoscope Investig Otolaryngol. 2020;1–7.