Otolaryngology, Head and Neck Surgery (Ear, Nose, and Throat)
Pillar Implants
About The Pillar Procedure
The Pillar Procedure is designed to reduce airway obstruction, a leading cause of sleep apnea, which occurs when breathing temporarily stops during sleep, and to reduce the instability in the soft palate tissue that can cause snoring.
The Pillar Procedure combines the use of three tiny inserts that are placed in your soft palate (the back portion of the roof of your mouth). The inserts support and stiffen the palate. This supporting and stiffening of the soft palate should last as long as the inserts are in place.
The Food and Drug Administration (FDA) regulates the manufacture and use of The Pillar Procedure in the U.S. The Pillar Procedure has been reviewed and cleared by the FDA for both obstructive sleep apnea and disruptive snoring.
What Causes Sleep Apnea and Snoring?
The noisy sounds of snoring occur when the airflow through the passages at the back of the mouth and throat causes instability in the soft palate tissue. The instability then causes these tissues to vibrate, which results in snoring sounds. Studies estimate that the soft palate contributes, entirely or in part, to 90 percent of all snoring.
As throat muscles relax during sleep, unsupported tissues in the back of the mouth (soft palate) and throat (pharynx) may collapse, blocking the airway or reducing its size. Airflow through the passages at the back of the mouth and throat create instability in soft palate tissue, causing these tissues to vibrate. This vibration results in the snoring sound.
In the case of sleep apnea, the airway is blocked when the palate collapses and blocks the airway during sleep. This can occur hundreds of times during the night.
Treatment
After first numbing the area with a local anesthetic, your physician will place three tiny inserts in your soft palate using a specially designed Delivery Tool. The inserts are made of a braided polyester material that has been used for many years in implantable medical products. After the inserts are placed, they should be invisible in the soft palate.
Some Individuals Require Treatments in addition to the Pillar Procedure.
The Pillar Procedure is effective in reducing airway obstruction caused by instability in the soft palate tissues. In addition to the palate, tongue size, enlarged tonsils, a large uvula (the soft tissue structure that hangs from the back of your mouth), and/or nasal obstruction can all contribute to obstructive sleep apnea (OSA) and snoring. Your physician will examine your airway to determine if other obstructions, in addition to the palate, contribute to your condition. If necessary, your physician will develop a plan to perform additional procedures to address these obstructions.
What to Expect After the Procedure
The procedure usually causes minimal discomfort and recovery time is short for most patients. Most patients resume a normal diet and activities the same day.
Pain and swelling are usually minimal. Most patients use only an over-the-counter pain reliever to treat discomfort. Over time, the inserts create a stiffening response in the tissue, which further supports the soft palate.
Possible Benefits
In most cases, patients soon report a noticeable reduction in snoring. In clinical studies, apnea and hypopnea events/hours of sleep, daytime sleepiness, and snoring were significantly reduced in patients with mild to moderate sleep apnea.
Potential Complications
Use of the Pillar Procedure involves potential risks including, but not limited to, those listed below. For more information about the following potential complications, please ask your physician:
- Difficulty swallowing
- Erosion of implant
- Gastro-intestinal obstruction
- Implant aspiration
- Implant rejection
- Implant migration
- Infection
- Mucosal edema
- Partial/full extrusion of Implant
- Sore or scratchy throat
- Voice/taste change
- Allergic reaction to implant material
Other Considerations
Even after treatment, your symptoms may not improve. Because the Pillar Procedure is relatively new, the long-term effects and consequences of the procedure have not been fully determined.
Unfortunately, most insurances do not cover Pillar implantation. After an initial visit and examination, if you opt for Pillar implantation, then you will likely need to pay for this procedure yourself. Call MetroHealth to schedule an appointment and inquire about costs and financial assistance.
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