title: Injection snoreplasty: investigation of alternative sclerotherapy agents.
abstract: OBJECTIVE
  Palatal sclerotherapy with sodium tetradecyl sulfate ("injection snoreplasty") was recently introduced as a safe and effective treatment for primary snoring. However, multiple other sclerotherapy agents also have excellent safety records and documented efficacy in the head and neck. Widely available and inexpensive agents were evaluated as potential palatal sclerosing agents for the treatment of snoring.
  
  
  METHODS
  A described canine palatal flutter model was used to evaluate the palatal stiffening efficacy of ethanol, doxycycline, and hypertonic saline in comparison to 3% sodium tetradecyl sulfate (STS) and a negative control (normal saline). Based on the animal study results, a human pilot study with ethanol was performed with subjective and objective data.
  
  
  RESULTS
  Ethanol was found to be equally effective as 3% STS in the canine model. Doxycycline was effective but less so, and hypertonic saline was comparatively ineffective. Palatal injection in human patients with 50% ethanol was found to produce equivalent subjective and objective snoring efficacy and equivalent pain and recovery time compared with 3% STS. However, there was a higher rate of transient palatal fistula with ethanol.
  
  
  CONCLUSIONS
  Injection snoreplasty with 50% ethanol is equally efficacious compared with 3% STS. There could be a higher fistula rate with the use of ethanol, although this complication has been self-limited and transient in every case.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Walter Reed Army Medical Center, Washington, DC, USA.
authors.forename: Scott E
authors.initials: SE
authors.lastname: Brietzke
authors.forename: Eric A
authors.initials: EA
authors.lastname: Mair
mesh_terms: D000818:Animals; D004285:Dogs; D004318:Doxycycline / Q000008:administration & dosage / Q000627:therapeutic use; D000431:Ethanol / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D007267:Injections; D010160:Palate, Soft / Q000187:drug effects; D010865:Pilot Projects; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage* / Q000627:therapeutic use; D012597:Sclerosing Solutions / Q000008:administration & dosage* / Q000627:therapeutic use; D015911:Sclerotherapy / Q000379:methods*; D012913:Snoring / Q000628:therapy*
chemical_list: D012462:Saline Solution, Hypertonic; D012597:Sclerosing Solutions; D000431:Ethanol; D004318:Doxycycline