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Sleep Apnea and Scarring

In the medical world, the word scarring has negative implications. Other similar words include growth, tumor, and lump, all of which are words used to describe certain anatomic features without any prognostic value. Whenever a doctor uses words "scar tissue," it evokes an image of a complication or adverse effect. However, with sleep apnea and snoring procedures, scarring is usually a good thing. 

Many of the procedures that are performed in the upper airway rely on fibrosis and scarring, not only to shrink the soft tissues, but also to tighten floppy structures and prevent either vibrations or obstruction. For example, many of the various soft palatal snoring procedures are dependent on significant scarring for good results. Whether it's using one of the minimally invasive procedures without any cutting (injection snoreplasty, radiofreqeuncy stiffening, or the Pillar implants), or the ones that involve cutting or tissue vaporizing (laser procedures and the UPPP), the appropriate level of scarring in the right place will determine whether or not the procedure is successful. Of course, sometimes, you'll have scarring in the wrong places, which can be complication.

In the nose, many of the turbinate procedures involve irritating, burning, or destroying the blood vessels and soft tissues underneath the mucous membranes. With time, scarring occurs inside the turbinates, with tightening and shrinkage, leading to better nasal breathing.

The challenge with many of the more "minimally invasive" snoring and sleep apnea procedures is that you'll tend to get minimal results. Most will work very well initially, but in my experience, there's a significant degree of recurrence years later. One of the main reasons for this is that these minimally invasive procedures usually only address one area. Obstructive sleep apnea, by definition, means that you have some degree of narrowing in multiple levels of your entire upper airway, from the tip of your nose to your voice box. Stiffening your soft palate when you have nasal congestion or tongue base collapse is not going to treat the problem definitively. In carefully selected patients, these minimal procedures can be useful, but many will need more aggressive, multi-level procedures later on.

Did you undergo one of the soft palatal stiffening procedures? Did it work for you? Please describe your experiences below in the comments box.