Snoring surgery usually the last snoring treatments choice after the failure of other teatments. Following are 5 major snoring surgery treatmetns.

1. Somnoplasty

Also referred to as Radio Frequency Tissue Ablation (RFTA), A minimally invasive procedure performed under local anesthesia that uses radiofrequency energy in the form of a needle electrode that discharges energy to reduce the soft tissue in the upper airway. After the procedure, the body reabsorbs the tissue. This procedure often requires more than one application.

2. UPPP

Also can be performed as laser assisted uvuloplasty (LAUP), this operation use for mild snoring. LAUP and UPPP eliminate the tissue at the back of the throat  and soft palate,  expansion of the airway in the throat entrance. UPPP treatment corrects the larynx excess uvula tissue, tonsils or adenoids increase and redundant tissues. . This procedure requires general anesthesia, and hospitalization and recovery time may be up to 3 weeks. After the operation, difficulty in swallowing during recovery could be a big problem. It can effectively reduce the snoring, the success rate of approximately 46-73%.

3. Nasal surgery

One produce for patients with nasal septum or nasal airway obstruction caused by other obstacles.

4. Mandibular maxillar advancement surgery

This procedure is usually used for snoring patients with craniofacial abnormalities or sleep apnea. Throuth the correction of throat or facial deformity to stop snoring and sleep apnea.

5. Genio-Glossus Advancement

The genioglossus is the major tongue muscle that retracts, advances and depresses the tongue. This procedure is primarily handled through the tongue to open the airway passage. Mainly used for obstructive sleep apnea treatment, it through the tongue suspension, to prevent the whereabouts back of the tongue to the throat during sleep. Insert a small screw lower jaw bone, and prevent this from happening. This process is usually reversible. In addition, the tongue reduction surgery can be carried out in order to minimize the size of the tongue, open the airway to eliminate snoring.

Here are the common treatment of snoring, including general treatment, pharmacotherapy, surgery, Plasma Coblation Technology, Continuous positive airway pressure machine and mouth correction device, Correction tongue snoring care and so on.

1. The general treatment of snoring

The treatment of snoring according to different causes, the choice of treatment is to determine the efficacy of the most important factor. We tell the story of four times the main method for treating snoring. First, speaking in general treatment.

• Weight Loss: Obesity is one of the factors causing the narrow throat.
• Weight loss can reduce the degree of airway obstruction.
• Quit smoking alcohol: smoking can stimulate the throat inflammation and swelling caused by a narrow throat, alcohol can make the muscles relax, the tongue base after the fall, thereby increasing the blockage.
• In addition, sedative sleeping pills before going to bed dissatisfied, and so on right side to sleep have some benefits to stop snoring.

2. Snoring pharmacotherapy

Modern medical research confirms that snoring occurs mainly due to the nose and nasopharynx, oropharynx and soft palate and the tongue occurred three narrow, blocking, coupled with relaxation during sleep pharyngeal soft tissue, tongue, etc. After the fall air can not freely through the pharynx leading to Department of airway. Snoring can be treated at home and abroad there are many drugs, acetazolamide, thyroxine tablets to promote metabolism, has a certain effect, medication can alleviate to some extent, but not cured. China from the U.S. introduction of snoring Fukang mouth lozenge, and spray can in a short time with the use of fundamentally cure snoring, they eliminate throat drug, strong immunity, fundamentally get rid of the root causes of snoring, cure, it would not relapse !

3. Snoring surgery

According to block plane to choose different surgical methods. If nasal obstruction in patients,  nasal surgery should be conducted, so that nasal passages unobstructed. Patients with narrow throat can choose UPPP, the operation is mainly through the removal of part of the uvula and the tonsils, pharynx increases the gap, thereby treating snoring, which is , the most commonly used surgical methods for the treatment of snoring and sleep apnea. The success of snoring surgery mainly depends on the surgical option.

4. Snoring low-temperature ablation plasma

Plasma Coblation technology is a newly patented technology, it is a good development of the minimally invasive treatment. Can make throat tissue ablation, the volume reduced, and can reduce the hypertrophy of the tongue. Because it is low-temperature treatment, partial response to small, basically no pain, no bleeding or bleeding very little, the operation time is short, may be the out-patient treatment, mainly applied to the nasal cavity, pharynx stenosis and patients with hypertrophy of tongue.

5. Continuous positive airway pressure machine and mouth correction device

Continuous Positive Airway Pressure machine (CPAP) and works by sleep wearing a mini-CPAP machines, masks and breathing machine connected to a similar principle of blowing balloons will be part of the expansion of the narrow throat. The pressure needed for each patient is different, so it requires a doctor to use polysomnography examination to determine an appropriate pressure. CPAP machines can significantly improve the blood oxygen content, for moderate to severe snoring, and other treatment failure patients.

6. Tongue snoring corrective physical therapy care

Is characterized by “oral organ Corrected”, that is to follow snoring mechanism, sets of dentures made of half-mouth shape, sleep wearing the entrance, fixed on the gums, through its specific biological function of the material occurs directly on the oral cavity in patients with deformed The location – above the soft palate and below Da Shetou, and then corrected based on physical and mechanical principles, to restore the proper internal organs in patients with mouth position and shape, forming a smooth flow of the respiratory tract, reduce and even eliminate snoring from the root.

Cautery-assisted palatal stiffening operation (CAPSO)  is a simple and safe office procedure that avoids the need for multiple-stage operations and does not rely on expensive laser systems or radiofrequency generators and hand pieces.

Principle:

CAPSO or electrical cautery, burns the palate causing fibrosis and consequent stiffening of the soft palate. It is also used a means to remove a longitudinal strip of mucosa along the soft palate or uvula.

This procedure is performed during a single out-patient visit under local anaesthetic.

Efficacy:

The success rate was initially 92% and dipped to 77% after 1 year. CAPSO eliminates excessive snoring caused by palatal flutter and has success rates that were comparable with those of traditional palatal surgery.

Because this procedure is less invasive than UPPP or LAUP there are generally fewer complications, however post-operative pain is similar to the other surgical methods. Data now available shows that the short-term efficacy is also similar to that of UPPP and LAUP. As with LAUP, CAPSO can be repeated until the desired effect on the snoring is gained.

Injection snoreplasty is a simple method of controlling snoring that is safe, inexpensive, and relatively pain free.

Principle:
The snoring sound is often produced by the vibrations of the soft palate and uvula when breathing. The principle is similar to several available snoring surgery options that eliminate snoring that works by reducing the flexibility of the soft palate and the uvula.

Injection Snoreplasty is the injection of a sclerosing agent into the soft palate, which  causes scarring and subsequent stiffening of the soft palate. This reduces the flutter of the soft palate, which is the cause of primary snoring.

The Technology:
During the first treatment Sotradecol is injected using a single needle penetration, into the midline soft palate using a needle bent to a 30 to 45 degree angleii. Approximately two minutes after the injection the area turns purple indicating the sclerosing agent is having an effect. Over the course of a few weeks, this leads to the formation of scar tissue and stiffening, which stops the vibration of the soft palate that causes snoring.

Efficacy:
In a study of 27 patients4 with a diagnosis of palatal flutter by sleep study, 25 patients (92%)reported a significant decrease in snoring.  Of these 25 patients that were successfullytreated, 22 (88%) completed a survey with an average follow-up period of 19 months. Fourpatients (16%) reported a relapse of their snoring after treatment. Three were re-injected and theirsnoring improved.

Summary:
Injection Snoreplasy appears to be as effective, in the short term, in reducing snoring, compared with other surgical treatments. Its long-term efficacy is unknown. It may a suitable alternative to other treatment methods due to its minimal cost and minimal postoperative discomfort.

Tongue suspension with Kit ReposeTM is a surgical mini-invasiveend-oral technique used in treatment of rear tongue obstruction.The base of the tongue is anchored with a non-reabsorbablesuture, held in place with a titanium screw, to themandible in correspondence to the geni apophysis of themandible; this loop should prevent the tongue, during sleep,from dropping backwards, favoured also by gravity and hypotonicityof the genioglossus muscle.

The Repose system was approved by the FDA in 1998. It consists of a titanium screw inserted into the lower jaw on the floor of the mouth and a suture passed through the base of the tongue that is then attached to the screw. The attachment holds the tongue forward during sleep.

Tongue suspension snoring surgery usually performed in conjunction with other procedures, this surgery is potentially reversible. No studies on the long-term success are available, and little clinical data to demonstrate the efficacy of the procedure have yet been published in a peer-reviewed journal.

Advantages:

• it is reversible, since no incision is made; and that it can be combined with UPPP, LAUP, or a tonsillectomy

Disadvantages:

• relatively long healing time (one to two weeks)
• it appears to be more effective in treating OSA than primary snoring.

As we have  mentioned that the frequently vibration of uvula and soft palate during sleep causing the distinctive sounds of snoring. Somnoplasty is an unique surgical method for reducing habitual snoring by removing tissues of the uvula and soft palate.

Unlike other approaches (such as the laser), somnoplasty uses a thin needle connected to a source of radiofrequency signals to shrink the tissues in the soft palate, throat, or tongue. It was approved by the Food and Drug Administration (FDA) for the treatment of snoring in 1997. The needle is inserted beneath the surface layer of cells and heated to a temperature between 158°F (70°C) and 176°F (80°C). The upper layer of cells is unaffected, but the heated tissue is destroyed and gradually reabsorbed by the body over the next four to six weeks. These burn- areas are eventually resorbed by the body, shrinking the tissue volume, opening the passageway for air, and thereby reducing symptoms of snoring.

Somnoplasty stiffens the remaining layers of tissue as well as reducing the total volume of tissue. Some patients require a second treatment, but most find that their snoring is significantly improved after only one. The procedure takes about 30 minutes and is performed under local anesthesia.

somnoplasty can also result in major complications, including:

• Prolonged pain, infection, bleeding, or impaired healing.
• Nasal regurgitation, a change in voice, or velopharyngeal insufficiency whereby liquids may flow into the nasal cavity during swallowing (rare).
• Thermal or electrical injury to the mucus membranes of the soft palate, uvula, or mouth. This may result in tissue loss by burn.
• Need for revision, or further and more aggressive surgery.

LAUP was developed in the late 1980s by Dr. Yves-Victor Kamami, a French surgeon whose first article on the technique was published in 1990. Kamami claimed a high rate of success for LAUP in treating a condition known as obstructive sleep apnea (OSA) as well as snoring.

Laser-assisted uvulopalatoplasty (LAUP) is one of the more commonly used treatments for snoring problems and for mild forms of sleep apnoea. It invovles a procedure that can be performed in your doctors surgery under local anaesthetic. A laser is used to vaporize part of the uvula, a small triangular piece of tissue that hangs from the soft palate above the back of the tongue.

Snoring Surgery Procedure

• First,  sprays a local anesthetic—usually lidocaine—over the back of the patient’s throat, covering the patient’s soft palate, tonsils, and uvula.
• Second, injecte more anesthetic into the muscle tissue in the uvula. After waiting for the anesthetic to take effect, the surgeon uses a carbon dioxide laser to make two vertical incisions in the soft palate on either side of the uvula. A third incision is used to remove the tip of the uvula

The surgeon also usually removes part of the soft palate itself. The total procedure takes about half an hour.

Drawbacks of LAUP

Through Kamami claimed a high rate of success for LAUP in treating a condition known as obstructive sleep apnea (OSA) as well as snoring. However other surgeons found it less effective than the first reports indicated leading the LAUP procedure has become controversial. Also, most patients suffer considerable pain for about two weeks after surgery.

Some people notice an increased dryness of the throat after the surgery, and your doctor will be able to provide you with a spray that should reduce this dryness. It is often a worry that should this surgery be completed and the snoring stop, then sleep apnoea can sometimes be left unidagnosed as snoring is the most common symptom.

Therefore, it is vital that you are given the right diagnosis before taking this treatment as if you are suffering from sleep apnoea and not snoring, a different procedure, or more caution, may be needed.

Uvulopalatopharyngoplasty, or UPPP, is the oldest and most invasive surgical treatment for snoring. It was first performed in 1982 by a Japanese surgeon named S. Fujita.

Uvulopalatopharyngoplasty (UPPP) snoring surgery is a procedure that removes excess tissue in the throat to make the airway wider. This sometimes can allow air to move through the throat more easily when you breathe, reducing the severity of obstructive  sleep apnea (OSA). The tissues that are removed may include: tonsils, part of the soft palate, and the uvula.

UPPP requires general anesthesia, one to two nights of inpatient care in a hospital, and a minimum of two weeks of recovery afterward.

Drawbacks of UPPP Snoring Surgery

• high cost
• lengthy recovery period
• It is not effective in treating snoring caused by obstructions at the base of the tongue.
• High relapse rate, between 50% and 70% of patients who have been treated with UPPP report that short-term improvements in snoring do not last longer than a year.
• It can result in major complications, including severe bleeding due to removal of the tonsils as well as airway obstruction and speech problems (The surgery may result in a nasal quality to the voice).

The main reason for the high failure rate of UPPP snoring surgery:

• 1, the majority of patients with upper airway obstruction occurred in the multi-level obstruction, UPPP can only lift the soft palate and the level of obstruction.

• 2, too much resection of vertical palate, soft palate  will lead to the destruction of velopharyngeal function, can cause choking and excessive consumption of nasal, Clinicians tend to make the Hypertrophy and long soft palate resection is not enough, which lead to surgery failed;

• 3, many conventional medical institutions to carry out the surgery under local anesthesia, For the patients who’s soft palate is too long and significant hypertrophy, local anesthesia is difficult to accurately grasp the surgical removal of the amount of the full removal of the plethora of organizations, which is one of the factors leading to surgical failure.

• 4, upper airway obstruction is a common cause of excessive oropharyngeal soft tissue areas, But it can also be found clinically in patients with upper airway due to peripheral muscle dysfunction caused by, such patients should not choose surgical treatment. In addition, the soft palate level obstruction in patients with severe single-UPPP can not be completely lifted.

Obesity is one of the most common cause of obstructive sleep apnea syndrome (OSAHS),  UPPP snoring surgery is still internationally recognized as one of the effective therapies for the treatment of OSAHS.

However, the success rate of UPPP snoring surgery for obesity obstructive sleep apnea is only 40-50%. Its high failure rate was mainly due to inappropriate surgical indications to grasp and hard to grasp the amount of soft palate resection. At the same time UPPP snoring surgery  can cause the destruction of velopharyngeal function, resulting in eating and language dysfunction.

Surgical methods:

Treated with general anesthesia or local anesthesia, according to the corresponding point in patients with velopharyngeal the mouth to the palate vertical position of vertex distance of 85-90% of the design of the new jaw hanging vertex, along the tongue palatal arch palatal arch and the new palatal pharyngeal hanging point for the purpose  shaped curve, the design line of remote organizations, the organization shall be required to remove excess.

After the design lines marked with methylene blue in turn both sides of the soft palate and lateral pharyngeal tissue operation, first of all along the arch wire and the surface of the tongue palatal arch incision for resection of soft palate mucosa and submucosal organizations and fat, revealing the tonsil. Peel from top to bottom hypertrophy tonsils, tonsillar artery and vein ligation, removal of pharyngeal arch in front of the palate mucosa, the palatal pharyngeal arch forward cover, close the pharyngeal side of the wound.

At last, removal of excess palatal down, hanging palate surgery to retain the roots of the appropriate side of the nasal cavity mucosa, and flip to the oral palatal surfaces exposed vertical wound closure to prevent postoperative scar contracture. Patients with nasal intubation back to normal wards, in addition to routine postoperative monitoring, care and things, and pay special attention: the complete suction tube secretions, prevent siltation and keep their smooth, close monitoring of patient oxygen. Oropharyngeal area according to the patients after 1-3 days of swelling in the removal of tracheal intubation, after extubation in patients with sleep may be secondary to positive pressure ventilation treatment and oxygen.