PROCEDURE

Anatomy plays an important role in predicting outcomes in the snoring patient. In general, the best candidates for TCRF palatoplasty (as is true for most other surgical treatments for snoring) are those with normal appearing soft palates and upper airways. The ideal candidate for treatment, therefore, would be a nonapneic (apnea/hypopnea index, AHI, 5), nonoverweight (body mass index, BMI, 25) individual with a hypervibratory but anatomically normal appearing soft palate, and no significant facial skeletal or airway soft tissue abnormalities, or confounding lifestyle factors (such as cigarette smoking). However, individuals with mild OSAS (AHI 15 and oxygen saturations no lower than 85%), who are overweight but not obese (BMI 30), have mild degress of palate variation (such as increased tissue bulk, uvula size, velum webbing), and treatable lifestyle (smoking, sedative medications) and soft tissue airway factors are also acceptable candidates. For this second group, which is usually more typical of those who seek treatment, successful outcomes in snoring control can be attained in approximately 84% of patients with TCRF palatoplasty (3). Successful snoring control diminishes as the above parameters worsen. Contributory upper airway soft tissue factors (enlarged nasal turbinates, tonsils, or tongue) can be treated by other in-office Somnoplasty

procedures, as described elsewhere in this book. For those individuals with very large, pendular uvulas, adjunctive in-office surgical partial uvulectomy may be needed.