Your doctor has recommended a palatal Palate Somnoplasty for you. The following information is provided to help you prepare for your procedure, and to help you understand more clearly the associated benefits, risks, and complications. You are encouraged to ask your doctor any questions that you feel necessary to help you better understand this procedure.

During normal breathing, air passes through the throat on its way to the lungs. The air travels past the soft palate, uvula, tonsils and tongue. When a person is awake, the muscles in the back of the throat tighten to hold these structures in place preventing them from collapsing and/or vibrating in the airway. During sleep, the uvula and soft palate frequently vibrate causing the distinctive sounds of snoring.

Palate Somnoplasty is a unique method for reducing habitual snoring by submucosal thermal lesions of the soft palate. Unlike other approaches (such as the laser), Somnoplasty uses low levels of energy to create finely controlled coagulative lesions beneath the mucosa. These radiofrequency lesions are eventually resorbed, reducing tissue volume and the symptoms of snoring. Palate Somnoplasty is performed under local anesthesia in an outpatient setting, taking approximately 30 minutes.

Originally, snoring treatment removed much of the loose tissue of the oropharynx, including the tonsils, uvula and a portion of the soft palate. Using general anesthesia, this UPPP is reserved for the most severe patients.

The next stage of therapeutic intervention used the CO2 laser and removed small amounts of tissue of the uvula and soft palate, often requiring 4 or 5 treatments.

Palate Somnoplasty is the third generation approach to snoring and apnea. Multiple treatments are still required but this can often be reduced to 2-3 visits, and the discomfort seems far less than the LAUP.

Because individuals differ in their response to Palate Somnoplasty, their anesthetic reactions and their healing outcomes, ultimately there can be no guarantee made as to the results or potential complications.

The following complications have been reported in the medical literature. This list is not meant to be inclusive. They are listed here for your information only, not to frighten you, but to make you aware and more knowledgeable concerning this procedure. Although many of these complications are rare, all have occurred at one time or another in the hands of experienced surgeons practicing the standards of community care. Anyone who is contemplating any type of surgery must weigh the potential risks and complications against the potential benefits of the surgery or any alternative to surgery.

• Failure to resolve or eliminate snoring. Most surgeons feel that about 80% of patients who undergo a Palate Somnoplasty will have a significant or complete resolution in their snoring; and an additional percentage of patients will notice reduced levels of snoring such that their sleep partners will report that the level is no longer offensive.
• Need for revision or additional surgery such as LAUP or Uvulectomy.
• Prolonged pain, infection, bleeding or impaired healing.
• Extensive palate injuries to cause fistula, a hole, which may not heal without, further surgery (rare).
• Nasal regurgitation, a change in voice or velopharyngeal insufficiency where by liquids may flow into the nasal cavity during swallowing (infrequent).
• Thermal or electrical injury to the mucous membranes of the soft palate, uvula or mouth. This may result in tissue loss by burn (rare).

You should not take aspirin or any product containing aspirin within 10 days of the date of your procedure. If there is any question as to the contents of a medication, please call the office or consult your pharmacist. Tylenol is an acceptable pain reliever.

Smokers should make every effort to stop smoking or at least reduce the number of cigarettes. This will help to reduce postoperative coughing and bleeding.

It is important that you know precisely what time you are to come to the office and that you allow sufficient preparation time. You should wear comfortable loose fitting clothes, which will allow for a conductive pad to be placed on the lower back area.

During the procedure, you will be fully awake throughout the entire process. Your surgeon will explain the process and demonstrate the equipment. The Palate Somnoplasty device, which is connected to a radiofrequency generator, is placed into the mouth. A small needle electrode is inserted into the soft palate.

Radiofrequency is applied through the electrode. Sections of the electrode are insulated to protect the delicate surface of the tissue. Through controlled delivery of radiofrequency energy, the tissue is heated in a limited area around the electrode. Most patients find the procedure to be surprisingly comfortable.

Snoring can be expected to be worse immediately after the procedure secondary to swelling of the tissues. Improvement is usually seen after one or two weeks and continues to occur for up to several months. A full 8 weeks should be allowed between each treatment.

You will be able to go home once you feel comfortable. Most patients can safely drive themselves home from the office. It is best to sleep with your head elevated at 45-degree angle several nights following the procedure. A sense of fullness in the back of the throat (due to uvula swelling) is commonly reported for several days. By keeping your head elevated above your heart, you can minimize edema and swelling. Applying an ice pack to the neck may help relieve swelling.

You may experience a sore throat for several days for which you may take Tylenol and/or Chlorseptic spray, or narcotics.

Do not eat or drink for three hours following your Palate Somnoplasty. After this time, you may advance your diet as tolerated. A follow-up appointment will be made.

Notify Your Doctor If You Have

• Extreme difficulty with swallowing.
• Difficulty with oral breathing.
• Sudden bleeding from the surgical site.
• Excessive pain uncontrolled by medications.

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11/18/03