Palatal implants for obstructive sleep apnea

Snoring is part of a spectrum of diseases that includes upper airway resistance syndrome and obstructive sleep apnea (OSA). Snoring is due to the vibration of the structures in the oral cavity and oropharynx. It usually bothers the spouse more than the patient. Owing to poor sleep quality, fragmented sleep, intermittent nighttime hypoxemia, reduced percentage of slow-wave sleep and increased sympathetic overdrive, OSA results in daytime somnolence, morning headaches, poor concentration, loss of memory, frustration, depression and even marital discord. Many surgical procedures of the soft palate focus on soft tissue volume reduction. The basis of each method is to create scar tissue, to incite fi brosis and to stiff en the palate, therefore resulting in reduced vibration and collapsibility of the soft palate. A new method involves the use of synthetic implants inserted into the soft palate. Palatal implants (Pillar® system, Restore Medical, St. Paul, MN, USA) are made of poly(ethylene terephthalate) (PET), a linear, aromatic polyester that was fi rst manufactured in the late 1940s. Current medical applications for PET include sutures, surgical mesh, vascular graft s, and cuff s for heart valves [9, 11]. Extensive research on PET has demonstrated its biostability [2], promotion of tissue ingrowth [1] and a well-characterized fi brotic response [10, 12]. Each soft-palate implant is cylindrical in shape, measures 18 mm × 1.8 mm, and is made of a porous and braided PET.