title: The velo-uvulo-pharyngeal lift or "roman blinds" technique for treatment of snoring: a preliminary report.
abstract: Snoring is caused by vibrating anatomical structures in the upper aerodigestive tract. It can be treated surgically and non-surgically, although resective procedures are associated with high postoperative morbidity and failure rate. We describe a new non-resective surgical procedure called the velo-uvulo-pharyngeal lift in which the soft palate is lifted, shortened, advanced and stiffened by means of permanent threads anchored to fibro-osseous attachments at the level of the posterior nasal spine and both pterygoid hamuli. Four adult patients (median age 44.5 years; range 42-65) affected by snoring and mild obstructive sleep apnoea-hypopnoea syndrome (apneoa-hypopnoea index, AHI < 20) requiring septal surgery under general anesthesia also underwent velo-uvulo-pharyngeal lift. There were no significant intra- or post-operative complications, and all of the patients reported immediate snoring relief. The main complaints were slight pain and a sensation of local fullness, both of which spontaneously disappeared within two days. The subjective clinical improvement in snoring was confirmed during post-operative follow-up (median 15.5 months; range 6-25), as was the stable reshaping of the soft velo-uvulo-pharyngeal tissues and enlargement of the mesopharyngeal space. There was also a decrease in daytime sleepiness. Our preliminary results suggest that velo-uvulo-pharyngeal lift is a simple, cost-effective and minimally invasive means of widening the mesopharyngeal space in snoring patients with or without mild sleep apnoea-hypopnoea syndrome. The widening of the mesopharyngeal space prevents contact-induced wall vibrations and its inspiratory obstruction causing hypopnoea and apnoea. It can also be combined with other procedures if indicated.
authors.affiliation: Fondazione IRCS Ca' Granda Ospedale Maggiore Policlinico, Department of Specialist Surgical Sciences, University of Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Mantovani
authors.forename: A
authors.initials: A
authors.lastname: Minetti
authors.forename: S
authors.initials: S
authors.lastname: Torretta
authors.forename: A
authors.initials: A
authors.lastname: Pincherle
authors.forename: G
authors.initials: G
authors.lastname: Tassone
authors.forename: L
authors.initials: L
authors.lastname: Pignataro
mesh_terms: D000328:Adult; D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods; D010160:Palate, Soft / Q000601:surgery*; D010614:Pharynx / Q000601:surgery*; D011446:Prospective Studies; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000601:surgery*; D012913:Snoring / Q000209:etiology* / Q000601:surgery*; D014609:Uvula / Q000601:surgery