Minimally invasive erbium laser treatment for selected snorers

Abstract

The aim of this paper is to present our results and experience in the treatment of snoring using the non-ablative Erbium: Yttrium Aluminum Garnet (Er:YAG) laser. Twenty-four patients (18 male and 6 female) with snoring problems due to soft palate hypertrophy were treated with 3 treatment procedures with Er:YAG 2940-nm laser (long pulse mode, 10 Hz, fluence 1.8-2.0 J/cm 2) performed at 2-week intervals. The treatment procedures were performed in outpatient settings. One treatment session lasts 15-20 min. Subjective (questionnaires) and objective (polygraph) outcome measures were assessed at baseline and 3 months after the final laser treatment. Wilcoxon Signed Rank was used to compare before and after scores. All polygraph variables showed some improvement 3 months after the end of treatment; however, only the reduction of the number of hypopnea episodes per hour was statistically significant (p = 0.034). In 13/24 patients, snoring time accounted for less than 5% of the sleep time after the treatment compared to 6/24 patients at baseline. The questionnaire survey showed statistically significant improvement in the quality of sleep and life of the patients as well as their partners after Er:YAG treatment (p < 0.001). The assessment of daytime sleepiness using the Epworth scale also improved 3 months after the end of treatment (p = 0.010). Based on our observations, the treatment of snoring with the Er:YAG laser is an effective and non-invasive therapeutic method. Further studies with long-term follow-up and a control group are warranted to confirm the promising results obtained in case series.

Treatment of snoring disorder with a non-ablactive Er:YAG laser dual mode protocol. An interventional study

“…Snoring is a common social problem worldwide, with studies indicating that 45% of people often snore, more often in man and elderly people ( 1 - 3 ). Snoring sound could result from the vibration of the oropharynx tissues when there is a partial collapse of the upper airways, specially of soft palate, lateral walls of the pharynx, and the base of the tongue ( 2 ).…”

“…Some studies also indicate a positive relationship between a high snoring and the risk of stroke and even death. Moreover, snoring is considered a problem and often causes marital problems, and may even lead the couple to sleep in separate rooms commonly ( 1 - 5 ).…”

“…Several risk factors contribute to this condition such as obesity, alcoholism, consumption of sedatives, smoking, old age, anatomical variations that causes airway obstruction including long soft palate and also uvula with a longer length, hormonal problems, low tonus of the muscles of the throat or tongue, and hypertrophy of tonsils ( 1 - 3 ).…”

“…The treatment modalities for this disorder may involve surgical and non-surgical procedures. The first intervention is related with the elimination of alcohol, smoking habits and promotion of exercise and controlled diet ( 1 , 3 ). Then, several options include mandibular advancement devices, or even positive pressure device (CPAP), here in cases of snoring associated to obstructive sleep apnea syndrome (OSAS) ( 1 , 3 ).…”

“…The first intervention is related with the elimination of alcohol, smoking habits and promotion of exercise and controlled diet ( 1 , 3 ). Then, several options include mandibular advancement devices, or even positive pressure device (CPAP), here in cases of snoring associated to obstructive sleep apnea syndrome (OSAS) ( 1 , 3 ). Surgical and highly invasive procedures such as uvulopalatopharyngoplasty (UPPP) and laser uvulopalatoplasty are sometimes indicated (LAUP) ( 1 - 3 , 7 , 8 ).…”