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| |  AAO-HNS: Sclerotherapy Provides Temporary Snoring Treatment By Ed Susman Special to DG News
DENVER, CO -- September 11, 2001 -- Injections of sclerotherapy agents into the soft palate controls snoring for at least 19 months in three fourths of patients, researchers reported at the annual meeting of the American Academy of Otolaryngology-Head and Neck Surgery in Denver, Colorado. "This snoreplasty procedure is very simple and effective, minimally painful, and very inexpensive," said Dr. Scott E Brietzke, an otolaryngology specialist at the Walter Reed Army Medical Center, Bethesda, Maryland. "All the equipment, including the drug used in this procedure costs about $40." However, Dr. Brietzke said his rate of relapse over the 19 months indicates that the treatment may not be the case in which a single injection proves to be a cure. "The scar formed during sclerotherapy is remodeled by the body over time," he said during his oral presentation, "softening the scar and allowing palatal flutter to recur." "This does not look like a curative treatment for snoring," he said. "But it does look like a very inexpensive way to control snoring." In the procedure, patients are first assessed to make sure they are candidates for snoreplasty. The patient is injected in the soft palate with 2 cc of a 3% solution of sodium tetradecyl sulfate. The ensuing irritation causes scar formation that induces stiffening of the palatal structures and reduces the snoring associated with palatal flutter. Dr. Brietzke said there can be some swelling in the area of the injection, but "in no way is there any compromise of the airway" which would impede breathing. He has successfully retreated a few of the patients whose snoring relapsed. The treatment is already being used by numerous doctors, Dr. Brietzke said. The sclerotherapy drug is in short supply, he said in response to questions from other doctors, because a major manufacturer has opted not to produce the substance because sodium tetracyl sulfate no longer has patent protection. "But stand by," Dr. Brietzke said, "other companies will be producing it soon." Numerous procedures, including surgery, radiofrequency procedures, laser technology, prostheses, and other treatments have been tried to reduce snoring. "If there are more than five ways to treat something in medicine, it usually means that none of them work very well," said Dr. Brian Hawkins, a clinical professor of otolaryngology at the University of Louisville, Kentucky. "And there are probably at least 25 ways to treat snoring. "However," Dr. Hawkins added, "this sclerotherapy treatment does look very promising." Dr. Brietzke said that the relapse rate of about 25 percent within 18 months to two years is similar to other treatments, but the low cost, high satisfaction and low inconvenience of sclerotherapy gives it an advantage over other therapies. In his study, Dr. Brietzke updated an earlier report on sclerotherapy for snoring. Originally, 25 of 27 patients were deemed as having successful treatment; after 19 months, 20 of those patients still report that their snoring is in check-about 74 percent. Of the people who relapsed and sought additional treatment, two of three said they got good results. Researchers used a series of tests to evaluate the treatment. One tests found that snoring loudness among the patients decreased from 11 decibels prior to treatment to 2 decibels afterwards.
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