Pillar procedure

Overview:

A pillar procedure is a surgical procedure done to treat snoring and obstructive sleep apnea (OSA). These are placed in the soft palate to reduce the airway vibrations. This minimally invasive surgical procedure stiffens the soft palate to reduce vibrations and the subsequent snoring. 

Obstructive sleep apnea: 

OSA is a most common breathing disorder caused during sleep. It occurs due to e excessive relaxation and collapse of the soft palate muscles. The soft palate is the muscular part that is a part of the roof of the mouth and is present behind the bony, hard palate. This excessive relaxation leads to narrowing and blockage of the airway causing repeated on and off breathing. This can also cause a decrease in oxygen levels and an increase in carbon dioxide levels. 

Snoring is a clinical sign of obstructive sleep apnea. OSA can cause excessive daytime sleepiness, loud snoring disturbing the adjacent people, dry mouth, sore throat, choking leading to sudden awakening at night, increased blood pressure, headaches, and mood alterations. OSA is treated by various modalities, of which pillar procedure is one. 

Pillar procedure: 

Pillar procedure is a simple, easy, reversible surgical procedure to reduce snoring and obstructive sleep apnea. This procedure uses polyethylene terephthalate rods that are placed in the soft palate with 2mm space between them. These are safe and biocompatible materials that can be placed in the mouth. They strengthen the soft palate by creating fibrosis and scarring through the property of foreign body reaction. 

Indications: 

Pillar procedure is indicated in individuals with severe snoring and obstructive sleep apnea. This is indicated when there is

• the necessity to stiffen the soft palate tissue, 
• reduce the severity of snoring, 
• reduce the incidence of airway obstructions
• Symptomatic and habitual snoring 
• Social snoring due to palatal flutter or airway obstruction 

Contraindications: 

This procedure is not for those

• Individuals with shorter soft palate, < 25 mm
• Individuals who are < 18 years old
• For obese individuals with body mass index ≥40,
• a recent significant change in the BMI is not indicated for the procedure. 
• Individuals with a previous history of surgeries in the palate or throat area are not indicated for the surgery. 
• Individuals with a previous history of surgeries for OSA or tongue obstruction are not indicated for the procedure. 
• Individuals with significant neurological, cardiovascular, psychiatric, or bleeding disorders are not indicated for the procedure. 
• Individuals with abnormalities in the head and skull, abnormal development of throat or palate area are also contraindicated for the surgery

Advantages: 

The advantages of the procedure are

• Better sleep quality due to reduced instances of snoring and OSA. 
• As the night sleep gets better individuals feel more relaxed. 
• Compared to other treatment modalities for OSA, this procedure is less invasive 
• It has the advantage of getting done at a doctor’s office
• It has a low risk of complications
• It can be carried under local anesthesia
• The recovery time is quick 
• Permanent results can be obtained that are long-lasting 
• Improved quality of life due to improved night sleep and fewer awakenings. 

Before the procedure: 

Before the pillar placement, one should discuss the procedure with the healthcare provider (HCP) and inform them of history regarding previous diseases, infections, surgeries, allergies, and the list of medications taken with the HCP. Some medicines might have to be stopped depending on the health condition and risk vs. benefits. These include over-the-counter medications, blood thinners, and opioid painkillers. Medicines will be prescribed before undergoing the surgery.

Physical examination of Ear nose, throat, and neck areas, airway passages, tonsils, soft palate, and tongue position is done. History regarding the OSA, sleep patterns, and snoring are taken from the sleep partner. Assessment based on a physical examination and history is done to understand the severity of OSA. 

During the procedure:

Pillar procedure is done under local anesthesia. Once the anesthesia starts numbing the area, implants are placed. Using a special delivery handpiece the first implant is placed in the soft palate at the junction of the bony and the muscular part. Certain markers on the handpiece indicate the length to which the handpiece has to be sent into the soft palate muscle. 

Using another instrument called the tongue blade, the junction is identified and the implants are placed. Another special device called the nasopharyngoscope is used to confirm the position of the implants. This is followed by placing the next two implants at least 2 mm apart.  With the help of the markers, the three implants are placed in the soft palate. 

After the procedure: 

The pillar procedure takes about 30 minutes to finish. One can return to their work after the procedure. Medications for pain and infection are given. Follow-up appointments are given to the patient to assess the function of the pillars. 

Risks and complications: 

Some risks and complications associated with the procedure are sore throat and discomfort after the pillar procedure that lasts for a few days. Infection at the site of pillar placement due to the surgery. Displacement or dislodgement of the pillars during placement reduces the effectiveness of the procedure. Palatal perforation that leads to complications. Partial extrusion of the pillars when they are placed too shallow or too deep is one of the complications. Occasionally placement of the pillars may also not improve the OSA and snoring. 

Conclusion: 

Pillar procedure is a safe and effective procedure for snoring and OSA. This is used to cause stiffening of the palate and reduce the severity of the snoring and symptoms of OSA. This increases the quality of sleep, mood, and the life of the individual and their partners. 

Popular Searches :

Hospitals: Cancer Hospital in Delhi | Best Heart Hospital in Delhi |  Hospital in Amritsar | Hospital in Ludhiana | Hospitals in Mohali | Hospital in Faridabad | Hospitals in Gurgaon | Best Hospital in Jaipur | Hospitals in Greater Noida | Hospitals in Noida | Best Kidney Hospital in Kolkata | Best Hospital in Kolkata | Hospitals in Rajajinagar Bangalore | Hospitals in Richmond Road Bangalore | Hospitals in Nagarbhavi Bangalore | Hospital in Kalyan West | Hospitals in Mulund | Best Hospital in India | | Cardiology Hospital in India | Best Cancer Hospital in India | Best Cardiology Hospital in India | Best Oncology Hospital In India | Best Cancer Hospital in Delhi | Best Liver Transplant Hospital in India

Doctors: Dr. Rana Patir | Dr. Rajesh Benny | Dr. Rahul Bhargava | Dr. Jayant Arora | Dr. Anoop Misra | Dr. Manu Tiwari | Dr. Praveer Agarwal | Dr. Arup Ratan Dutta | Dr. Meenakshi Ahuja | Dr. Anoop Jhurani | Dr. Shivaji Basu | Dr. Subhash Jangid | Dr. Atul Mathur | Dr. Gurinder Bedi | Dr. Monika Wadhawan | Dr. Debasis Datta | Dr. Shrinivas Narayan | Dr. Praveen Gupta | Dr. Nitin Jha | Dr. Raghu Nagaraj | Dr. Ashok Seth | Dr. Sandeep Vaishya | Dr. Atul Mishra | Dr. Z S Meharwal | Dr. Ajay Bhalla | Dr. Atul Kumar Mittal | Dr. Arvind Kumar Khurana | Dr. Narayan Hulse | Dr. Samir Parikh | Dr. Amit Javed | Dr. Narayan Banerjee | Dr. Bimlesh Dhar Pandey | Dr. Arghya Chattopadhyay | Dr. G.R. Vijay Kumar | Dr Ashok Gupta | Dr. Gourdas Choudhuri | Dr. Sushrut Singh | Dr. N.C. Krishnamani | Dr. Atampreet Singh | Dr. Vivek Jawali | Dr. Sanjeev Gulati | Dr. Amite Pankaj Aggarwal | Dr. Ajay Kaul | Dr. Sunita Varma | Dr. Manoj Kumar Goel | Dr. R Muralidharan | Dr. Sushmita Roychowdhury | Dr. T.S. MAHANT | Dr. UDIPTA RAY | Dr. Aparna Jaswal | Dr. Ravul Jindal | Dr. Savyasachi Saxena | Dr. Ajay Kumar Kriplani | Dr. Nitesh Rohatgi | Dr. Anupam Jindal 

Specialties: Heart Lung Transplant | Orthopedic | Cardiology Interventional | Obstetrics & Gynaecology | Onco Radiation | Neurosurgery |  Interventional Cardiology | Gastroenterologist in Jaipur | Neuro Physician | Gynecologist in Kolkata | Best Neurologist in India | Liver Transfer | Best Cardiologist in Delhi