Why do many people snore?

Snoring is a common problem. In most cases, however, it is not a "disease", but simply the disturbing result of a change or enlargement in the palate caused by excess tissue. When a person relaxes in sleep, the posterior (soft) palate will relax as well and collapse slightly. If the palate is larger than usual already, the airflow has to pass through a "bottleneck". The air presses through the constricted passage in the mouth, and the soft palate in the posterior part of the mouth with the so-called uvula starts to vibrate. The vibration is what causes the snoring noise.
What can be done? By using the fairly new and gentle method of radiofrequency volume reduction (RaVoR™), the ENT doctor is able to reduce and stiffen the posterior part of the palate. This is done under local anaesthesia by inserting a fine probe into the palate. A carefully measured amount of radiofrequency energy is administered through the probe and heats the application area. The tissue treated with heat decomposes with the help of the body's own immune system. This purposely caused, natural healing process leads to a volume reduction of the tissue and thus the stiffening of the soft palate. It may take a few weeks for the desired effect to show fully. After the intervention, light or moderate pain may occur in the mouth and throat, but will disappear or can be treated with painkillers. It is not unusual for slight swellings to occur in the palate, but those will go down again within a few days. Consult your ENT doctor to find out more about the possible, but rare side effects following this intervention. After the stiffening takes place, air may flow freely through the throat. Most of the time the snoring noise is reduced or disappears as verified by a number of clinical studies that have been done.
This small surgical intervention is performed under local anaesthesia on an out-patient basis and will not take longer than a few minutes. Afterwards the patient is able to get up and leave the surgery immediately and on his own. Post-operative follow-up, sick-leave or even a stay at the hospital is generally not needed. Occasionally a second or very rarely a third treatment is necessary to achieve the best result possible.

After the intervention, light or moderate pain may occur in the mouth and throat, but will disappear or can be treated with painkillers. It is not unusual for slight swellings to occur in the palate, but those will go down again withina few days. Consult your ENT doctor to find out more about the possible, but rare side effects following this intervention.

Snoring: Why a new snoring treatment?

What is RaVoR™?

RaVoRT is short for Radiofrequency Volume Reduction. The term says it all in a nutshell. When treating socially disruptive snoring, the goal is to enlarge the air passage in the mouth while stiffening the soft palate. This is best achieved through short and selective heating of certain tissue areas. Special probes administer radiofrequency energy produced by an radiofrequency unit and cause deliberate local lesions without burning the mucosa. Following the intervention, the treated tissue is decomposed by the body's own immune system and transformed into fibrous scar tissue inside the soft palate. This process leads to a stiffening of the soft palate.

The complete treatment will usually not take longer than 15 to 20 minutes. It is performed on an out-patient basis and is almost without pain for the patient. Two or three treatments are usually necessary for best results.

The radio-frequency medical device is from Sutter Medizintechnik GmbH of Freiburg Germany.

What is special about Sutter's technology?

The simple answer is AutoRF™!

AutoRF™ is a function that constantly controls and adjusts the power output of the radiofrequency unit. If radiofrequency is applied for too long, the system automatically adjusts and reduces the output by up to 65 % to prevent undesired tissue damage.

Some clinical highlights about Outpatient Snoring Treatment with Sutter's BM-780 II Bipolar Precise

1 Indications and patient selection

Patients with a primary obstruction in the soft palate. Nasal obstruction is often associated
with this indication. Ocassionally webbing of the posterior pillars as well as enlarged lingual
tonsils can be observed. These indications may also be treated with these electrodes.

Contraindications:
Patients who suffer from a medium or serious case of sleep apnea (hypopnea-apneaindex/
RDI . 30). Further diagnosis and treatment such as pressure respiration is recommended
to such patients.
Pregnant women, patients with a cardiac condition, diabetes or other serious disease.

2 Patient preparation

The patient agrees in writing to undergo the surgical intervention.
The optimum position for the intervention is for the patient to be seated.
Injection of local anesthesia into the palate ( 3-5 points) and other parts of the anatomy as deemed necessary. Wait 10-15 mins.

4 Use of the bipolar electrode in the soft palate/posterior pillar of tonsils/tongue base.

The thin insulated part of the needle is inserted completely underneath the mucosa to avoid surface necrosis.
Care is taken to avoid damage to the uvula.
3 to 4 points chosen for the insertion in the palate.
The RF current is activated only after the electrode has been correctly placed in the palate.
RF current is activated for 5-9 seconds per lesion.

5.Use of the bipolar electrode in the inferior nasal turbinates

Place the first insertion point in the submucosa at the head of the conchae. Insert the electrode
completely in the submucosa in parallel position to the osturbinale. Insert the thin insulation
of the needle completely to avoid necrosis of the surface tissue.
Activate RF current only after the electrode has been correctly placed.
The second insertion is placed approx. 15mm behind the first puncture.
Insert the electrode again in parallel position to the osturbinale.
If necessary, insert the electrode a third time approx. 15mm behind
the previous lesion.
Activate RF current for 5 to 9 seconds per lesion.

6. Post-treatment of patient

It is advisable to review the patient 24 hours after surgery for check-up.
For 2 to 3 days after the surgery the patient should only eat food that is easy to swallow
(mild, not too hot or cold, soft). Warn the patient that slight difficulties in the act of swallowing
might occur for 1 to 2 days following the surgery.
Advise smokers to refrain from smoking for 2 to 3 days after the surgery.
When treating the lingual tonsils, prescribe bicarbonate soda or antibacterial mouth-wash to
the patient. The prophylactic antibiotics may me advisable.
Apart from these precautions the patient is able to resume his routine tasks right after the
surgical intervention.
Prescribe an analgesia and nasal spray containing cortisone (for oral application) for use in
case of pain or if oedema should occur.
Inform the patient that for the first few days following the surgery the snoring noise may be
more pronounced than usual because of oedema until the healing has further progressed.

7.Complications

Frequently mild oedema will occur in the velum and the uvula for the first 24 to 72 hours
following the surgery of the soft palate.
Frequently hyperaemia of the palate can be observed for 4 to 6 days following the surgery.
A whitish yellow, ulcerlike discoloring may occur around the lesions during surgery and will
fade within two weeks following the surgery.
Tiny ulceration and fibrine coating are quite common after treatment of the lingual tonsils.

Sutter Medizintechnik GmbH
Tullastraße 87
D-79108 Freiburg
Germany

Source: This page is adapted from information provided by Sutter Medizintechnik GmbH