Palatal Pillar Implants

Turbulent Breathing

In an awake individual, there is usually enough muscle tone in the throat, palate (roof of mouth) and tongue to keep an open airway and allow clear airflow.  As a person starts to relax, those muscle start to lapse, and the airway becomes more crowded.  Once the walls of that airway passage get close together, that proximity combined with their loose state causes the linings to vibrate.  This turbulent airflow leads to snoring.  It can be quite impressive in volume, snorers often scoring well above 70 decibels (for example, conversational speech takes place at 50 decibels).

Pillar Implants

For years, airway surgeons have tried different ways to reduce and stiffen the soft tissues of the airway, thereby reducing this turbulent breathing.  The tonsils and palate have been the most convenient locations to concentrate the effort, as they are redundant enough to be reduced without compromising function.  The down side to palate reduction is that sometimes too much can be removed, leading to problems swallowing long term.  In the short run, the procedure is painful, requires some time off work or school and can lead to short term bleeding and dehydration.

The palate reduction procedure (often referred to as the UPPP, UP3, or uvulopalatopharyngoplasty) fell out of favour among airway surgeons for the longest time.  It has regained a foothold once again, now that there exists better selection criteria for these patients.  However, one of the newest techniques for reduction of turbulent palatal vibration has been with palate implants.

These Pillar Implants, produced exclusively by Restore Medical, are implanted directly into the soft tissue of the palate.  They are permanent woven implants, made of inert materials that will not be rejected, nor are they composed of dangerous biological material.  They induce scar formation across the soft palate from the inside out, which leads to decreased movement, even when the muscle tone is relaxed during sleep.  This leads to decreased snoring volume.  It has been eliminated altogether in some patients.

Pillar Implants are placed under a local anesthetic in the clinic in under an hour.  Three to five implants are placed under the surface of the palate lining, therefore are not seen when you open your mouth.  Some people feel an initial scratchy feeling in their throat for a few days after the procedure, but people can go back to work immediately and go back to normal diets the next day.

Results

The results for the Pillar Implant System have been excellent.  When selection criteria are met after an interview and examination by a trained airway surgeon, bed partner satisfaction rates have improved post implantation by 80%.   The best success rates are determined by the surgeon selecting the right patient for the procedure rather than the procedure itself.  It has been shown to help some patients with obstructive sleep apnea.

Complications are rare with Pillar Implants.  Over 45,000 implants have been placed, and there have been no major adverse event recorded.  There is a small risk of an implant working its way out of the throat (1%) and sometimes need to be removed by the airway surgeon.  There is also the risk that despite the reduction in snoring volume achieved by the Pillar Implant Procedure, it is still too loud for the bed partner.