Patient Selection and Efficacy of the Pillar Implant Technique for Snoring and OSAHS

Problem: Stiffening the soft palate using a palatal implant is an innovative technique, introduced for clinical practice in 2003. This is a simple, office-based procedure with minimal morbidity. Our objective was to identify (1) the success rate using subjective symptoms and objective improvement of OSAHS; (2) the success rate based on Friedman's clinical stage to develop patient selection criteria; and (3) the technique's value as an adjunctive or revision procedure.

Methods: The study was a retrospective chart review of the first 100 patients undergoing the Pillar implant. Data collected included: previous treatments for snoring and/or OSAHS, adjunctive procedures, preoperative and two-month postoperative snore level, Epworth sleepiness scale (ESS), PSG, and complications. Charts were grouped as follows: group I had no adjunctive and previous treatments; group II received adjunctive nasal and/or tongue base procedures; and group III had previous UP3.

Results: Patients with primary snoring and mild and moderate OSAHS were treated. The AHI level was not a predictor of success. Group I patients (n = 36) had significant improvement in snoring levels, but not in ESS or AHI. Twenty-six patients (72.2%) were considered successful based on elimination of symptoms. Group II patients (n = 43) had the best results. Mean AHI and ESS improved and snore level decreased. Thirty-five patients (81%) were rated as successful. Group III (n = 21) patients had no change in AHI or ESS but showed significantly decreased snoring. Twelve patients (57%) were rated as successful. Complications were limited to 4 patients with partial extrusion.

Conclusion: The Pillar implant is an easy and effective office-based procedure to treat snoring and OSAHS in selected patients.

Significance: This study demonstrates the efficacy of the palatal implant technique alone and in combination with adjunctive procedures in decreasing snoring levels and treating OSAHS.

Support: None reported.