Pillar Procedure Helping Treat Sleep Apnea


 
An implant used in the Pillar Procedure.

Dr. M. Boyd Gillespie Finds Success in Reducing Snoring

A Memphis physician is using a snoring procedure that he has found to be successful in treating patients with sleep apnea.

Boyd Gillespie, MD, an otolaryngologist and head and neck surgeon for UT Methodist Physicians and Professor and Chair of the Department of Otolaryngology- Head and Neck Surgery at UTHSC has treated patients with chronic snoring for 10-years with the Pillar Procedure, an in-office treatment under local anesthesia which implants threads that stiffen the palate to reduce the vibrations that create the snoring sound.

Since snoring can originate from the nose, palate and/or tongue, the first step is evaluating the patient to identify the snoring site. Snoring from the tongue can be treated with a bite guard whereas palate snoring can be treated with the Pillar with some patients benefiting from both methods. Snoring is often a symptom of sleep apnea.


Dr. M. Boyd Gillespie

According to FAIR health, sleep apnea claims have increased 850 percent nationwide from 2014 to 2017. For many patients, sleep apnea is caused by obesity and from aging. As the body ages, tissues soften and can cause the airway to be blocked. The pillar procedure helps stiffen the collapsed tissue to prevent the flutter and snore. As our population ages, we may continue to see more cases of sleep apnea.

After evaluating the patient and determining the snoring site and severity of sleep apnea if present, Gillespie numbs the throat with a topical spray andlidocaine injection. The threads are implanted, with an average of four to five implants for men and three to four for women, depending on the palate size. "Over 90 days the implants stiffen the palate and reduce the vibrations that create the snoring sound. Typically we see a 50 percent reduction in snoring intensity which gradually improves over a 90 day period. Usually the snoring is reduced enough that is no longer bothersome and is less frequent during the night," says Gillespie.

"Pillar has been around for 10-years, but we have more research now that describe how the optimize results," said Gillespie. Previous treatments for snoring included nasal surgery and tonsil removal, which are costly procedures performed in the operating room. Pillar "has an excellent safety profile, the major risk is occasionally one of these threads can work their way out," says Gillespie but this is very rare and not painful for patients. The Pillar Procedure is nondestructive to tissues and works by reinforcing collapsible tissues instead of painful tissue removal. "Patients are able to resume a soft diet immediately [after the procedure] and a regular diet within a few days," says Gillespie. Patients who experience discomfort following the procedure can treat pain with over-the-counter painkillers instead of opioids, which Gillespie says make sleeping and breathing worse.

Patients with mild to moderate sleep apnea are also finding success with the Pillar Procedure, which can reduce sleep apnea by an average of 10-blockages per hour.

Sleep apnea is divided into three levels of severity - mild is 5-15 blockages per hour, moderate is 16-30 blockages per hour and severe is 30 or more blockages per hour. For those with mild to moderate sleep apnea, Pillar can improve symptoms by reducing the number of blockages per hour. "Even patients on CPAP can benefit from Pillar if they have a tendency to wear the CPAP only part of the night. The ideal patient, however, has socially disruptive snoring without daytime sleepiness and is at low risk for sleep apnea," says Gillespie.

Patients with sleep apnea with associated heart disease or stroke are not strong candidates for the Pillar Procedure.

 
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