The Pillar procedure is a creation of Medtronic, Inc., a Surgical Technologies business venture that deals with the development and distribution of procedural solutions and products for surgical application including:
- Ear, nose and throat
- Neuron-spine, cranial and orthopedics
- Surgical oncology
The company headquarters is in Minneapolis, USA. The motivation underlying the engineering of the Pillar Procedure was to avail a minor, non-invasive mild surgery that would help alleviate nighttime snoring and mild to moderate OSA.
The surgery aims at stiffening the soft palate tissues usually located at the back of the throat and mouth. As you may already know, snoring is associated with collapsing of the throat tissues which lead to blockage of the upper airway of the tracheal system. Stiffening these tissues would therefore prevent them from collapsing or vibrating.
The procedure is normally performed by a specially trained surgeon who inserts minute, tightly woven implants into the soft palate using a special delivery tool pre-loaded with implants.
Obstructive sleep apnea is a serious sleep condition where a person doesn’t only chronically snore, but also has prolonged pauses in their breathing. The Medtronic Pillar Procedure was designed as a more permanent solution to this sleep condition.
Comprehensive Details about the Procedure
The first thing that the surgeon will do when one goes in for their procedure is to give the patient a local anesthetic and antiseptic mouthwash.
The doctor will then use a tool with a long, curved handle, preloaded with the first implant to navigate the center of your throat; close to the uvula where the soft palette begins and the hard palette ends. He will use this same tool to create a small narrow cut, using a small tubular blade on the gadget, and then release the pillar-like implant by releasing trigger on the device.
The surgeon will use the same steps in placing additional implants on the left and right side of the first insertion less than 2mm apart.
The pivot of this procedure is actually when the implants are inserted. And this will generally take less than 20 minutes to be completed.
The pillar-like implants are each about 18mm long with a 2mm outer diameter. Since no soft tissues are removed on implantation, the patient recovers faster without any post-surgical discomfort. The implants are composed of terephthalate, a type of tightly woven polyester that has been used over the last 50 years in a variety of implantable surgical products.
The doctor will normally independently make the decision of placing 3 or 5 implants, although 5 is more common with most doctors believing that the extra 2 implants will be more effective. There has not been any medical or scientific research to prove or dispute this.
How Long After Surgery Will I See The Results?
The body will naturally initiate the growth of tissues around the implants, a process called fibrotic response (fibrosis). The process will stiffen and harden the soft palate and create the additional support for preventing collapse or vibration of the tissues into the airways in the throat as you sleep.
Please note that the implants, on their own, don’t eliminate the occurrence of OSA or snoring, but the growth of the hard scar tissues round the implants eventually stiffening the soft palette tissues is what does. And the growth of the hard scar tissues doesn’t happen overnight, so you won’t appreciate the results of your surgery for about 4 to 6 weeks after. Nevertheless, people are unique and will therefore heal at different speeds. But on average it will take 3-12 months for the hard scar tissues to completely encase the implants.
Expected side effects
The recovery period for this procedure is very minimal. A majority of patients are actually able to go about their daily activities; eating, talking, laughing, and drinking as usual, a few hours after surgery. Moreover, the pillars are very discreet and will hardly be noticed by any other person. You are also not expected to experience too much discomfort apart from being aware of the foreign body in your throat; a feeling that is likely to fade away after a while.
Since this is a surgical operation involving incision, you are likely to have some minimal pain in your throat. There is also the risk of infection and the possibility of your body rejecting the implant making it uncomfortable for you and giving you no other option than to have it removed.
There are also those extremely rare cases where the procedure has been seen to lead to increase of Obstructive Sleep Apnea and snoring thereby frustrating the patient and their loved ones.
According to the initiators of this Pillar Procedure, any complications that arise from it can be simply reversed by removing the implants. However, the hard scar tissues are technically expected to remain even after the implants have been removed.
Is The Medtronic Pillar Procedure Scientifically Justified?
Several clinical studies have been carried out to confirm the effectiveness of the pillar procedure and the manufacturer claims that these yielded extremely positive results. However please note the following contradicting issues that arise from these studies:
- The research carried out was funded by the manufacturer and the findings were therefore expected to be in their favor.
- According to these studies, emphasis on the effectiveness of the pillar procedure is more on its ability to reduce the intensity of snoring and the incidence of OSA than its ability to stop these all together.
- Some of the studies showed that about 80% of patients confessed a significant reduction in their amount of snoring after their surgery.
- Seven other studies published in an issue of Laryngoscope underwent a meta-analysis which confirmed that the pillar procedure was only effective in reducing the loudness of snoring and decreasing OSA from Mild to Moderate.
Will The Procedure Be Effective In Your Case?
Well the question of the effectiveness of this procedure for your individual case is really dependent on:
- What your case is
- The cases of OSA that the procedure works on
Please realize that the pillar procedure was designed to target the most common reason for OSA which is the collapse or vibration of the soft palate tissues.
According to completed studies, 80% of cases of OSA and chronic snoring result from the collapsing of excess or unsupported tissues at the back of the throat which consequently destructs the flow of air. The rest of the cases (about 20%) result from other causes from adenoids, blockage of nasal airways and tonsils. That’s why it’s important to consult your doctor before taking on this procedure just in case you don’t fall in the 80% statistic of people it will work for.
Let’s talk money,
In the event that you have passed the test on your suitability for the procedure, the next natural concern would be; how much will it cost you? For starters, treatments for snoring are mostly considered cosmetic. As a result, there are very few medical insurance or Medicare that give cover for it. So you might probably be forced to fund your treatment.
Generally the cost of this procedure will depend on your doctor and his specialty, and the number of implant that will be used. In most cases this is about 1,500 – 2,200$ but could be higher.
Due to the high cost of the procedure, a majority of individuals may not be able to afford it. However even those who can afford it are advised to do their homework well especially on the doctor they choose. Many people tend to have the notion that cheap doctors are not very qualified; this may or may not stand true. You will only know if you research well and even get references from people the specific doctor has done the procedure on. One thing is for sure though, the more experience the doctor has on this procedure, the better his qualifications may be.
Even with the huge quantity of clinical studies that support this procedure, public feedback from Yelp users still reveal a huge number of people that were dissatisfied with their results. However, we will not pin this procedure down based on these, since the results of any procedure are different for individuals and patients have varying degrees of OSA and snoring. This procedure was designed for mild to moderate OSA, so people with severe OSA might find it somewhat disappointing.
The pillar procedure is like any other treatment and is therefore not 100% guaranteed solution. In addition to that, it is costly and the results take a while to show. In considering how effective it is and whether it is the right approach for you, ask yourself the following questions:
- This procedure is like a cosmetic treatment so is it very essential?
- Is there another less invasive procedure that can solve your condition?
- Is this procedure more effective than other alternatives?
- Can you afford this procedure?
Since I was diagnosed with chronic snoring, I have used different mouth guards that have proved effective in helping me manage my snoring. Not that I didn’t have an idea about the Pillar procedure, I just find it somehow invasive and extremely expensive yet not really more effective than mouth guards. Although mouth guards are not a luxurious solution, you will only be wearing them during sleep and should therefore not bother you much. I suggest you try the mouth guards first before settling on the surgery.