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Pillar Procedure

Sleeping redhead woman

Palatal stiffening procedures utilize implants or injections placed into the soft palate in the back of the throat to tighten the source of snoring. Dr. Pasha has utilized numerous soft palate stiffening strategies including The Pillar Procedure, Elevoplasty, Injection Snoreplasty, and radiofrequency techniques. These applications are typically performed in the office and considered for those who snore without sleep apnea or mild sleep apnea. 

In general, Dr. Pasha is extremely selective who may be candidates for these techniques. He has witnessed inappropriate applications of palatal stiffening procedures. These techniques are typically not covered by insurance and have had variable success especially in the long-term. Since Dr. Pasha has been practicing sleep medicine since 2001, he is better suited to determine legitimately if you may be a candidate.

Procedure

There are many techniques that Dr. Pasha has utilized to directly stiffen the most common source of snoring – the soft palate (the soft part of the top of the mouth). For select patients, these techniques are performed in the office in one visit under local anesthesia by “freezing” the throat using sprays, gels, and Lidocaine. 

The actual stiffening occurs through the following methods:

  1. Implants (Pillar Procedure, Elevoplasty): small, synthetic polyester “pillar” implants (2 mm in diameter) are placed inside the soft palate to cause scarring and to stiffen the palate.
  2. Injection: a chemical (Sotradecol) is injected into the palate that causes an inflammatory reaction that leads to stiffening of the palate.
  3. Radiofrequency: a probe is placed into the soft palate and a current is applied to cause eventual fibrosis or scarring of the soft palate. 

The type of technique considered will depend on your anatomy and severity of your snoring/sleep apnea. A upper airway evaluation will be performed prior suggesting any technique. 

Pillar procedure diagram

FAQ about Palatal Stiffening Procedure

How long do the procedures take?

The procedures typically may be completed in the office within thirty minutes. You should plan to be in the office for about one hour in order to prepare and complete the paperwork.

What are the risks of the procedures?

Because these procedures are performed in the office, severe complications are extremely rare.

Minor complications include the extrusion (sticking out) of the implant. Extrusion of the implant occurs slowly and often is only partially extruded. If this occurs, Dr. Pasha may replace the implant or leave it depending on how long the implant has been in place.

This procedure does not affect swallowing or significant voice changes.

A more comprehensive list of potential complications will be discussed in the office.

Does it hurt?

Since the procedure is done in the office, recovery is much quicker with less discomfort. Dr. Pasha uses sprays and gels to numb up the area prior to any injection. This reduces the discomfort of the injection considerably. Pain after the surgery varies widely. Generally speaking, one should anticipate soreness in the area for a few days after the procedure.

What can I eat after the procedure?

Most people resume a normal diet the same day or within a few days after the procedure.

What kind of results should one expect?

Although we cannot guarantee success for everyone, clinical studies have shown that many of these procedures may reduce snoring with a 70-80% bed partner satisfaction rate in select patients and can reduce the severity of mild sleep apnea.

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