Sleep apnoea and snoring is a common disorder and is present in about 20% of the population, out of which only 2-4% have obstructive sleep apnea. The majority of others have snoring without sleep apnea. These set of patients with snoring without sleep apnea are suitable for surgical procedures to help with their snoring. Traditionally the results of surgery for snoring have been disappointing. The reasons for this are inadequate investigations prior to surgery to identify the exact level of obstruction causing the snoring.
The traditional sleep studies like pulse Oxymetry and polysomnography only suggests if the patient has sleep apnea or not but it does not tell the Surgeon where exactly the level of obstruction is, which is causing the snoring. This is very useful for the Surgeon to plan his surgical procedures.
The Apnoeagraph study is a form of pharyngeal manometry, which is very useful in evaluating patients with, sleep disorders that might be suitable for surgical intervention. This study not only tells us if a patient has got sleep apnea or not but also gives us the exact level of obstruction in these patients. This is very important and helpful for the ENT Surgeon, as he can plan the surgery according to the site of obstruction, hence giving a much better post-operative result.
Traditionally surgical procedures for snoring have been performed with cold steel, diathermy and LASER. The problems with all these procedures are post-operative pain. The new technique of Coblation is a low temperature (40-70 degrees centigrade) plasma excision has now been used extensively in various surgical specialties such as Orthopedics, Spine & Neurosurgery, Otorhinolaryngology, Urology and Laparoscopic surgery. Coblation is a proven medical technology, which has been used on over five million patients worldwide. The unique properties of Coblation technology enable rapid controlled removal of tissue at relatively low temperatures while maintaining the integrity of surrounding tissues or structures.
Scientific and clinical studies have proven that Coblation technology is a safe and effective method of tissue removal. There have been several studies to prove that the use of Coblation based surgical approach is capable of promoting a controlled angiogenic response. We successfully manage and treat; degenerative joint arthritis, tendon and muscle injuries, non specific joint aches and pains and other musculoskeletal conditions, ensuring full recovery by applying a non-surgical approach.
Apnoeagraph and Coblation technology is been used in Snoring Clinic at Manchester UK for all our patients with snoring and sleep apnea, the results have shown that preoperative Apnoeagraph analysis is very important in determining the success of surgery. In a recent Audit we had complete reduction of snoring in about two thirds of the patients who had surgery.
Problems with snoring or sleep apnoea ?
An initial consultation and assessment with Mr Yousuf Saleem, Consultant ENT Surgeon. During this assessment the patient will undergo some general investigations including Body Mass Index, Epworth Sleepiness Score, a lifestyle questionnaire and an examination of the nasal airway and throat. A comprehensive medical history is taken and discussion with the patient (and where possible your bed partner) the types of treatment available.
Patient will then be fitted with an Apneagraph device, which helps us identify the specific reasons for your snoring. The patient either sleeps in the hospital or goes home with the device and comes back in the morning for its removal. The next morning the results are analyzed to check if patient is suitable for Surgery.
Because snoring and sleep apnea are often multi-factorial conditions with a variety of contributory factors, is it unlikely there will never be one single universal cure for snoring. Therefore, accurate assessment is essential to guide appropriate treatment. Apnoeagraph results will exactly establish what is the level of obstruction for the snoring patients and hence the Surgery is planned according to the results.
This involves partial excision of the uvula (the structure that dangles at the back of the throat and which normally vibrates to create the noise of snoring), as well as scarring of the soft palate by creating small channels on either side of the uvula. This is done using low-temperature plasma energy delivered via a surgical instrument into the soft palate. This results in an area of scarring and hence stiffening of the soft palate. In individuals with large obstructive tonsils, these can also be removed as part of the procedure if necessary.
To deal with turbinate enlargement, nasal polyps or enlarged adenoids, this may help snoring by overcoming nasal obstruction.
Surgery is planned and discussed with the patient and a date is given to have the surgery within 3-4 days.
Surgery is usually a day case procedure.
Patient will be reviewed in clinic one week following his surgery and then again in 2-3 months time.
Your consultation at Aset Hospital Surgery Centre, and will last approximately one hour. During your initial consultation, Mr Yousuf Saleem will provide a full assessment and discuss your desires and requirements. You will be able to get answers to all of your questions and concerns about snoring and / or sleep.