If you have suffered the less than accommodating effects of nighttime snoring or OSA (obstructive sleep apnea), you might have heard of the Pillar Procedure or have sought out other alternatives as a means to resolve your snoring issues, if not for you then at least for your sleep deprived partner.
The Pillar Procedure was engineered as a minor and relatively non-invasive surgery that looks to alleviate nighttime snoring and mild to moderate obstructive sleep apnea. The success of the procedure rests in successfully stiffening the soft palate that rests at the back of our mouths and throat.
In doing so, it looks to prevent any possible tissue vibration or the collapse of tissue generally associated with blocking the upper airway of our tracheal system, and resulting in snoring and or OSA.
The pivotal aspect of the procedure relies on a specially trained surgeon inserting minute, tightly woven implants into the soft palate with the use of a sterile delivery tool in which the implants are loaded before insertion.
Who Engineered It?
The procedure was created by Medtronic, Inc., a Surgical Technologies business that develops products and procedural solutions for surgical applications which include: neuro-spine, cranial and orthopedics; ear, nose and throat; and surgical oncology. Headquartered in Minneapolis, the company is a global influencer in medical technology.
Understanding the Procedure
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The main bulk of the procedure, the insertion of the implants, is a simple operation and seldom lasts more than 20 minutes or so. Prior to insertion, patients are supplied with an antiseptic mouthwash and a local anesthetic.
The surgeon then casually makes use of a device boasting a long, curved arm with which the initial implant is placed in the center of where our hard palette ends and our soft palette begins (close to the uvula).
This same device has a small tubular blade that creates a small, narrow incision where the pillar-like implant is released by the click of a trigger. Additional implants are then subsequently placed on the right and left sides of the first insertion, each no more than 2 mm apart.
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Each implant is approximately 18 mm long and has an outer diameter of approximately 2 mm. It is introduced into the soft palate without the need to remove any soft tissue and thus reducing recovery time and any post-surgical discomfort. The implants themselves are made of polyethylene terephthalate, essentially, a tightly woven type of polyester that has been popularly used for the last 50 years in all kinds implantable medical products.
Although it is in the doctor’s discretion to either use 3 or 5 implants, most doctors tend to favor the use of 5, with the belief that an extra set of 2 implants provides better results. The latter assertion however has of yet, no scientific research to back its claim.
Once the implants are placed, the body will begin a natural process of fibrotic response (fibrosis), through which tissue will begin to grow around the implants. Thus hardening or stiffening the soft palate and creating the added support necessary to prevent its vibration or it’s collapsing into our throat airways during sleep.
However, it is important to note the implication that this is a process that happens over time. The implants alone do not instantly alleviate the occurrence of snoring or OSA, but rather, it’s the growth of hard scar tissue around the implants that ultimately stiffens our soft palette.
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Because of this, significant results aren’t normally appreciated until about 4 to 6 weeks after the procedure. Moreover, given the fact that different individuals heal at different speeds, complete encasing of hard scar tissue around the implants can last about 3 months, to as much as 12 months.
Adverse Side Effects
Despite the slow results, the procedure itself has minimal recovery time and most patients are able to talk, eat and drink freely after it. In addition to this, the pillars should not be visible or create any form of discomfort, besides an initial awareness of a foreign object in your throat, which quickly fades over time.
However, like any operation that requires any kind of incision you will experience some slight throat pain. Also, there is always the possibility of infection, and there have been cases in which the body rejects the implants, which is by no means comfortable and will require that your doctor remove them.
In stranger cases, the procedure has also been found to aggravate the incidence of snoring or obstructive sleep apnea. Much to the misery of the patient and likely their previously mentioned sleep deprived partners.
It’s important to note that the manufacturers of the procedure claim that any complications are reversible by simply removing the implants. Because the hard scar tissue remains even after the implants are removed, the latter claim on its reversibility is only true on technicality.
What Does The Science Say?
Although various clinical studies funded by the manufacturers of the Pillar Procedure attest to it’s being effective, there is a distinction to be made about what the word effective entails.
Yes, sufficient scientific research has shown the procedure’s success, but rather than report on its ability to stop it, they have attested its success in reducing the incidence of OSA and the intensity of snoring. According to some of these studies, approximately 80% of patients demonstrated a reduced amount OSA.
Moreover, a meta-analysis examining another seven studies published in an issue of Laryngoscope concluded that the Pillar Procedure significantly reduced snoring loudness and mild-to-moderate obstructive sleep apnea.
Will It Help Your Case?
Before deciding on the Pillar Procedure as the answer to your prayers, it’s important to address the questions of: Which cases of OSA does it treat? And what is the cause of your particular case?
As we already saw but did not point out, the Pillar Procedure was made to address the most common culprit of OSA: The vibration or collapse of the soft palate. During sleep, the muscles in the upper airway of our throat relax. This allows for unsupported or excess tissue in the back of the mouth and throat to collapse, thus impeding proper airflow. Overall, studies suggest that the soft palate is involved in more than 80% of snoring and obstructive sleep apnea incidences.
However the other 20% can be caused by various other reasons, such as blockage of the nasal airway, tonsils, and adenoids. Before deciding on this procedure, consult your doctor on what the particular causes of your OSA or snoring problems are and whether or not you fall into the outlying 20%.
How Much Does it Cost?
Considering how suited you are for the treatment takes us to the next aspect of your decision, its cost. For reasons that seem largely arbitrary, snoring treatments are viewed as cosmetic and are not covered by any health insurance or Medicare. So keep in mind that all costs will be out of pocket.
Although prices will vary depending on your doctor, his credentials and the amount of implants used, the average prices for the procedure bank at around $1,500 to $2,200 or more. Knowing this, there’s no crime in considering the procedure financially inaccessible to some patients.
Furthermore, whether you decide or not on the operation, it’s important to conduct a significant amount of research before choosing a doctor. So give it the old college try and don’t cheap out. Better a qualified physician than a more inexperienced, affordable one. Although there is no rule of thumb for this, the cheapest doctors are by no means always the best doctors. Although that’s not to say the expensive ones are prized bulls either.
Even though there is a body of clinical work to back it’s validity, it won’t take you a day’s work of Google search to find numerous patients and disgruntled Yelp users claiming the procedure was little to no help.
Then again, we have already mentioned its varying results times, and there is always the fact that some cases of snoring and OSA are more extreme than others. Making complete recovery harder or impossible.
The procedure was, after all, designed for mild to moderate obstructive sleep apnea.
If You’re Still Wondering
Like all treatments, the Pillar Procedure is not promised as a 100% effective. Also, it is a relatively costly procedure and results are not immediate.
To answer the question on its suitability we can perhaps consider its being treated as a cosmetic treatment: are cosmetic treatments essential?Likely not. However, to those who can afford it they provide the comfort of resolving an issue without the extended use of another apparatus, like a mouth guard or a respiratory aid.
The questions on whether or not the Pillar Procedure works, and how much it costs are perhaps best treated, in this case, if rephrased to the following:
Does it work any more than other alternatives?
And if so, can I afford the commodity?
On my own account, from personal experience and being a glass-shattering snorer myself, I’d recommend trying the mouth guard first. It is the least invasive method and it’s by degrees more affordable. It’s not terribly glamorous but hey, its just sleep time, lights are off anyhow!
Which Product Should I Choose?
Every person has a unique mouth and needs, so one that is perfect for one person may not be the best option for another.
There are well over 100 products on the market, so making a decision can be quite daunting.
You will find a lot of helpful information in the comparison chart, and I have written reviews of several products.
If you would rather not spend a lot of time reading reviews, please consult my article titled “My Mouthpiece Recommendation”. I have compiled a list of three products that I believe are the best options, based on my experience.