Scott E Brietzke1, Eric A Mair. 1. Department of Otolaryngology-Head and Neck Surgery, Walter Reed Army Medical Center, Washington, DC, USA.
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. STUDY DESIGN AND SETTING: 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 AND SIGNIFICANCE: 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.
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. STUDY DESIGN AND SETTING: A described caninepalatal 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 humanpatients 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 AND SIGNIFICANCE: 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: Carlos O'Connor-Reina; Maria Teresa Garcia-Iriarte; Juan Carlos Casado-Morente; Diego Gomez-Angel; Alfonso Rodriguez-Diaz; Guillermo Plaza-Mayor Journal: Eur Arch Otorhinolaryngol Date: 2008-06 Impact factor: 2.503