A very common throat operation, adenoidectomy surgically removes the adenoids, masses of lymph tissue in the back of the throat that work with the tonsils and immune system early in life to defend the body against invading bacteria and viruses. Occasionally the adenoids become infected and, after repeated infections, enlarged, causing breathing and swallowing problems such as snoring, disturbed sleep, chronic mouth breathing (possibly resulting in deformations of the face and mouth), ear infections and hearing loss.
Snoring
Forty-five percent of normal adults snore at least occasionally, and 25 percent are habitual snores. Problem snoring is more frequent in males and overweight persons, and it usually grows worse with age. Snoring is an indication of obstructed breathing. Therefore, it should not be taken lightly. An otolaryngologist can help you to determine where the encumbrance may be and offer solutions for this noisy and often embarrassing behavior.
People who snore may suffer from:
Poor muscle tone in the tongue and throat. When muscles are too relaxed, either from alcohol or drugs that cause sleepiness, the tongue falls backwards into the airway or the throat muscles draw in from the sides into the airway. This can also happen during deep sleep.
Excessive bulkiness of throat tissue. Children with large tonsils and adenoids often snore. Overweight people have bulky neck tissue, too. Cysts or tumors can also cause bulk, but they are rare.
Long soft palate and/or uvula. A long palate narrows the opening from the nose into the throat. As it dangles, it acts as a noisy flutter valve during relaxed breathing. A long uvula makes matters even worse.
Obstructed nasal airways. A stuffy or blocked nose requires extra effort to pull air through it. This creates an exaggerated vacuum in the throat, and pulls together the floppy tissues of the throat, and snoring results. So, snoring often occurs only during the hay fever season or with a cold or sinus infection.
Also, deformities of the nose or nasal septum, such as a deviated septum (a deformity of the wall that separates one nostril from the other) can cause such an obstruction.
What treatments are available?
Treatment depends on the diagnosis. An examination will reveal if the snoring is caused by nasal allergy, infection, deformity, or tonsils and adenoids.
Snoring or obstructive sleep apnea may respond to various treatments now offered by many otolaryngologist-head and neck surgeons:
Uvulopalatopharyngoplasty (UPPP) is surgery for treating obstructive sleep apnea. It tightens flabby tissues in the throat and palate, and expands air passages.
Uvulopalatopharyngoplasty (UPPP) is surgery for treating obstructive sleep apnea. It tightens flabby tissues in the throat and palate, and expands air passages.
Thermal Ablation Palatoplasty (TAP) refers to procedures and techniques that treat snoring and some of them also are used to treat various severities of obstructive sleep apnea. Different types of TAP include bipolar cautery, laser, and radiofrequency. Laser Assisted Uvula Palatoplasty (LAUP) treats snoring and mild obstructive sleep apnea by removing the obstruction in the airway. A laser is used to vaporize the uvula and a specified portion of the palate in a series of small procedures in a doctor's office under local anesthesia. Radiofrequency ablation-some with temperature control approved by the FDA-utilizes a needle electrode to emit energy to shrink excess tissue to the upper airway including the palate and uvula (for snoring), base of the tongue (for obstructive sleep apnea), and nasal turbinates (for chronic nasal obstruction).
Genioglossus and hyod advancement is a surgical procedure for the treatment of sleep apnea. It prevents collapse of the lower throat and pulls the tongue muscles forward, thereby opening the obstructed airway.
If surgery is too risky or unwanted, the patient may sleep every night with a nasal mask that delivers air pressure into the throat; this is called continuous positive airway pressure or " CPAP ".
Do you recommend the use of over-the-counter devices?
More than 300 devices are registered in the U.S. Patent and Trademark Office as cures for snoring. Some are variations on the old idea of sewing a sock that holds a tennis ball on the pajama back to force the snorer to sleep on his side since snoring is often worse when a person sleeps on his back. Some devices reposition the lower jaw forward; some open nasal air passages; a few others have been designed to condition a person not to snore by producing unpleasant stimuli when snoring occurs. But, if you snore, the truth is that it is not under your control. If anti-snoring devices work, it is probably because they keep you awake.
Self-help for the light snorer
Adults who suffer from mild or occasional snoring should try the following self-help remedies:
