Patients should be cautioned that the procedures will not work immediately, because scar tissue has to form. Also, because scar tissue softens and droops over time, relapses eventually occur in most patients.
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November 2015Injection snoreplasty, in which an injection is made into the fluttering part of the palate to cause scarring, is another option, Dr. Brietzke said, but it does not address the uvula. “The uvula is usually my determining factor on which one I reach for,” he said. If the uvula doesn’t look worrisome, he probably starts there; if it does, he may move on to something such as a CAPSO, in which a midline palatal scar is induced.
Other Treatments
Oral appliances such as a mouthpiece, which can reposition the jaw or the tongue, can be effective if the problem isn’t the palate, Dr. O’Connor said. Medical
interventions such as pseudoephedrine, the anti-nausea medication domperidone—not available in the United States—and the antidepressant protriptyline have shown some benefit in studies, probably due to their neurologic effects and changes to the tone of the muscles. “There’s a variety of different reasons for why that may occur, but it’s something certainly to consider,” Dr. O’Connor said. Nothing is currently available at this point, however, and these medications need to be studied further.
Interventions such as pillows, lubricants, and stents have not been found to have significant effects across a large group of patients when studied, Dr. O’Connor added. For select patients, these products may be beneficial, but determining which ones they may assist can be difficult.
Oropharyngeal exercises, developed after it was observed that users of the didgeridoo were found not to snore, can also help with muscle tone. Dr. Brietzke said the effect is “not overwhelming” but is definitely present.
*The speakers’ comments are their private views and do not reflect the official views of the Department of the Army or the Department of Defense.
Thomas Collins is a freelance medical writer based in Florida.
Take-Home Points
- All office procedures to correct snoring due to palatal fluttering have success in the 80% range, so the decision on which to use should involve other factors.
- If the uvula is long or bulky, this problem should be addressed or success will be limited.
- Patients should be counseled that they will not see immediate results and that relapse over the years is common, because scar tissue softens and droops.