Snoring Surgery (Uvulopalatopharyngoplasty)
Snoring is an extremely common complaint. It’s cause may be multifactorial but it’s effects can be significant on the individuals quality of sleep and often as significant on their partners sleep pattern. Snoring can be a cause of discontent in relationships and partners often present having had to sleep apart due to the noise created.
Snoring occurs at different levels in the upper airway and can happen at more than one site. Typical palatal snoring occurs due to flutter of the palate on breathing. Pharyngeal wall collapse and tongue base collapse can also cause significant turbulence to the airway and cause noise on breathing whilst asleep.
It is important to distinguish simple snoring from ‘Apnea’ which is a cessation of breathing that has significant cardiorespiratory consequences that must be investigated further. If these symptoms are present then often a sleep study should be performed in order to investigate for obstructive sleep apnea. Any patient who suffers from snoring complaints should complete an Epworth Sleepiness Score to assess the effect of their snoring with respect to their daytime alertness / somnolence.
Sleep nasendoscopy is a technique used to artificially create sleep using anaesthetic agents and then to examine the different levels that snoring occurs at. A flexible telescope is passed through the nose as the patient drifts of to sleep and starts snoring. The various levels are inspected to see where the snoring is generated from and from this the patient may be advised sensibly with respect to appropriate treatments.
When the problem is mainly palatal flutter and some lateral pharyngeal wall collapse it is possible to undertake a UVPPP. This operation stiffens the palate and lateral pharyngeal walls by removing the tonsils and the uvula. This operation is an exquisitely uncomfortable operation and requires regular pain relief post-operatively.
Mandibular advancement prosthesis
Advancement prosthesis are available to draw the mandible and the tongue forward preventing them from collapsing whilst asleep. In doing so the turbulence that is created from this obstruction may be relieved. A number of prosthetic splints are available on the market and are reasonably priced.
Epworth Sleepiness Score
Please score the questions below using the following scoring system:
0 = no chance of dozing
1 = slight chance of dozing
2 = moderate chance of dozing
3 = high chance of dozing
- What is the chance of dozing when sitting and reading?
- What is the chance of dozing when watching TV?
- What is the chance of dozing when sitting inactive in a public place (e.g in a meeting)?
- What is the chance of dozing as a passenger in a car for an hour without a break?
- What is the chance of dozing lying down to rest in the afternoon?
- What is the chance of dozing sitting and talking to someone?
- What is the chance of dozing sitting quietly after a lunch without alcohol?
- What is the chance of dozing in a car, while stopped for a few minutes in traffic?