How likely are these procedures to be around long term? (injections, implants,etc.) How easy are they to perform? It seems there would be a large amount of people seeking surgery for snoring and or sleep apnea? Is this assumption correct?
Snoring procedures
- Thread starter 1217MD
- Start date
- Joined
- Feb 11, 2002
- Messages
- 948
- Reaction score
- 222
Sclerotherapy, Somnoplasty, and Pillar implants are all easy to perform. LAUP is a little more challenging. Whether they will work in the long run is up for debate. However, as long as people are fat, lazy, and have money, these procedures will be offered for years to come.
- Joined
- Oct 2, 2006
- Messages
- 912
- Reaction score
- 30
Could not agree more. I would say that the procedures which only induce scarring will not last and thus not be around for years to come. All scars tend to soften over time, and therefore the efficacy tends to decrease as well. The pillar procedure is unique in that it will theoretically constantly induced scar formation, but because it has not been around for 20 years we don't yet know what the long-term results are for it.
Snoring treatments in general will be around forever in one form or another and will always pay because they will never be covered by insurance
I didn't realize that insurance does not cover these procedures. What would the indications for implants be? I imagine there are many people out there that snore, but I am sure a large portion of those are obese and have sleep apnea. Could they still get implants? Or would they not be candidates due to other things causing their problem like obesity, etc?
- Joined
- Feb 11, 2002
- Messages
- 948
- Reaction score
- 222
Well, "indicated" is a loosely sutured term for these kinds of things. Is this what the company says? Is this what the physician says? Is this what the Academy says?
The company would say Pillar implants are indicated for snoring, mild sleep apnea and moderate sleep apnea. Some physicians might even say they are indicated for severe sleep apnea.
In my opinion, I would say they are indicated for snoring only. And this would be in a patient I have definitely ruled out sleep apnea with a PSG or for a patient who is so obviously not an apneic by history and examination.
- Joined
- Feb 11, 2002
- Messages
- 948
- Reaction score
- 222
I think this is one thing, for better or for worse, that will keep ENT floating. As long as we have procedures that are elective, people will at some point or another pay for them.
- Joined
- Oct 2, 2006
- Messages
- 912
- Reaction score
- 30
Generally, Pillar implants are indicated for snoring in those with a BMI <31. Studies show that they will reduce the AHI by an average of about 8 points. If the ultimate goal is to get the AHI < 15 where CPAP is no longer a "needed" therapy, it is therefore not a great option for those with an AHI > 23. I generally don't recommend it for those > 20. Pillar implants are one thing that insurance won't cover for OSA therefore most won't choose that route anyway so it's usually a moot point. There are many reasons where Pillars are not a good idea--large tonsils, thick long muscular palates, h/o previous palatal injury including injection snoreplasty, BMI > 30, unrealistic expectations, etc.
