Patient Selection and Efficacy of Pillar Implant Technique for Treatment of
Snoring and Obstructive Sleep Apnea/Hypopnea Syndrome
Friedman M,
Vidyasagar R,
Bliznikas D,
Joseph NJ.
Department of Otolaryngology and Bronchoesophagology, Rush-Presbyterian St.
Luke's Medical Center, Chicago, IL; Division of Otolaryngology, Advocate
Illinois Masonic Medical Center, Chicago, IL.
OBJECTIVE: Pillar implant (PIT) is a simple, office-based procedure with
minimal morbidity that was introduced in 2003 to treat snoring and
mild/moderate obstructive sleep apnea/hypopnea syndrome (OSAHS). We studied
the: (1) success rate using subjective symptoms and objective
polysomnographic improvement; (2) success rate based on BMI, OSAHS severity
and Friedman tongue position (FTP); and (3) its value as an adjunctive or
revision procedure.
STUDY DESIGN AND SETTING: Retrospective review of 125
patients who underwent the PIT for snoring and OSAHS. Patients were grouped:
Group I had PIT only (n = 29); Group II received adjunctive nasal procedures
(n = 37), Group III received adjunctive oropharyngeal procedures (n = 55);
and Group IV had failed previous UPPP (n = 4).
RESULTS: Overall subjective
and objective "cure" rates were 88.0% and 34.4%, respectively. Group IIb had
the best objective cure rate of 46.7%. Neither AHI nor BMI correlated with
outcome measures, whereas FTP did correlate. (FTP I and II had improved
success vs FTP III and IV). Ten patients had partial extrusion of the PIT.
These were removed and new PIT were carried out at a later date.
CONCLUSIONS: Based on a short-term study, the Pillar implant is an effective
treatment for snoring and OSAHS in selected patients and can be combined
with adjunctive procedures to treat OSAHS. EBM rating: B-3b.PMID: 16455363 [PubMed
- as supplied by publisher]
From Mike:
For extreme emergency cases this may be a viable short term solution until the person has fully developed their
breathing. Begin
here
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