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General Otolaryngology

Hope for Snoring

Snoring is a problem shared by more than 25 percent of the population. It occurs more frequently in men and people who are overweight. Habitual snoring disrupts a family’s peaceful night’s sleep. Snoring also disturbs the snorer’s own sleep patterns, resulting in a feeling of being tired, even after what seems like a good night’s sleep. Habitual snoring makes a restful sleep nearly impossible for everyone. A snorer, however, is helpless to control or stop the snoring. At Cleveland Clinic, an ENT doctor can offer some snoring treatments.

Obstructive Sleep Apnea

Some snorers may experience the most serious form of snoring, called obstructive sleep apnea. Obstructive sleep apnea is characterized by loud snoring, which is interrupted by frequent periods when breathing is restricted (hypopnea) or actually stops (apnea). This disorder is sometimes fatal if apnea extends over longer periods of time and becomes more frequent. Many snorers are unaware of the implications of the problem of obstructive sleep apnea. A laboratory sleep study can be performed by an ENT doctor to determine the extent and severity of obstructive sleep apnea.

Causes of Snoring

Snoring occurs when the airway becomes physically obstructed. This may be caused by poor muscle tone in the throat and tongue, which allows them to collapse and fall back into the airway. Snoring also occurs with enlarged tonsils and adenoids or with a long palate and/or uvula. These obstructing tissues vibrate loudly when the person breathes, resulting in a snoring sound. Snoring treatments used by Cleveland Clinic's Head and Neck Institute allow patients to sleep without disturbance.

Treatments for Snoring

Non-Surgical Snoring Treatments

More than 300 snoring treatment devices have been developed to prevent snoring, including special pillows, dental bites and chin straps. People have even sewn tennis balls into the backs of pajamas to keep from snoring. These snoring treatments are based on behavior modification and do not physically correct the underlying anatomical problem.

Laser Snoring Treatments

A Cleveland Clinic ENT specialist often offers laser surgery with a local anesthetic to correct the anatomic cause of snoring by trimming the uvula and soft palate. Laser snoring treatments are usually done in the doctor’s office with the patient fully awake and sitting in a chair. A complete snoring treatment consists of one to three sessions, each four weeks apart. Each session takes only 15 to 30 minutes.

Afterward, the patient is able to eat, speak and return to daily activities. A severe sore throat is experienced by some patients following snoring treatments. Medication is available as necessary. A reduction in snoring after the first session is common. After the snoring treatments are completed, 85 percent of patients report that their snoring has been helped.

Radiofrequency Treatment

The latest and least invasive surgical measure for snoring treatments is radiofrequency coagulation. After local anesthesia is administered, radiofrequency energy is delivered directly by an ENT specialist via an insulated needle to the tissue producing snoring. The needle remains in the tissue for approximately three minutes, during which time hardening occurs. One to three applications at six week intervals may be necessary to achieve the desired results.

A non-surgical procedure and limited amount of postoperative discomfort are significant advantages of radiofrequency snoring treatments.

Insurance Coverage for Snoring Treatments

Currently, most insurance companies do not pay for the snoring treatments as a distinct, isolated problem. Some patients undergo sleep studies, which confirm the severity of their sleep disorder, thereby rendering treatment insurable. In most cases, snoring is caused by several anatomic factors that jointly block the airway during sleep. Correction of these factors, such as nasal obstruction, enlarged tonsils and abnormalities of the palate, is covered by insurance.

Am I a Candidate for Radiofrequency Surgery?

An initial consultation with an ENT specialist will help to determine if radiofrequency snoring treatments are appropriate such as somnoplasty is appropriate for you. A somnoplasty uses radiofrequency energy to create lesions beneath the uvula and soft palate. The somnoplasty causes stiffness of the palate that can eventually stop snoring.

This information is for educational purposes only and should not be relied upon as medical advice. It has not been designed to replace a physician’s independent judgment about the appropriateness or risks of a snoring treatment procedure for a given patient.

Abnormal Sense of Taste and Smell

What are the symptoms of abnormal sense of taste and smell?

Abnormal sense of smell can refer to either a decreased or absent sense of smell, smelling odors that are not really present, or the inability to identify odors. These can significant affect quality of life for a patient, causing anxiety and decreased enjoyment of food. Changes in taste and smell can occasionally be dangerous for patients, such as when you cannot smell smoke or other warning odors.

What causes abnormal sense of taste and smell?

The most common causes of smell disorders are nasal and/or sinus disease, viral upper respiratory infections, and head trauma. The most common causes of taste disorders are upper respiratory tract infections and head injuries. Other infrequent causes of both include masses in the nasal or oral passageways, endocrine problems, side effects from medications, and degenerative processes of the brain.

How are these diseases diagnosed?

The first step in diagnosis is a thorough history and physical examination. It is important to provide information to your doctor regarding respiratory illnesses, nasal or sinus symptoms, history of trauma, other medical conditions, and medication use.

What are the treatments of taste and smell disorders?

Treatments of taste and smell disorders are directed towards the underlying cause. Nasal or sinus conditions should be managed with either medication or surgical therapy, depending on the severity of the disease. Endocrine disorders such as hypothyroidism should be treated appropriately. Medications that may be causing the smell and/or taste disturbance can sometimes be substituted with another medication.

Ear Wax Impaction (Cerumen)

What is cerumen impaction?

Cerumen impaction is trapping of ear wax in the ears.  If this is severe, it can cause hearing loss.  Occasionally, cerumen impactions can lead to ear infections with bacteria or fungus growth.

What are the symptoms of cerumen impaction?

If mild, no symptoms may be present.  Most commonly, cerumen impaction leads to a “plugged up” feeling in the ears.  If severe, it can cause hearing loss, ringing in the ears, pain, and occasionally, dizziness. 

What causes cerumen impaction?

Some people are more prone to impactions than others, either because they produce more wax or have small ear canals that trap the wax.  Using cotton swabs can make this problem worse by pushing the wax further into the ear canal.

How is cerumen impaction diagnosed?

An exam with an otoscope (lighted instrument used to look in the ear) will reveal whether ear wax is present.

What is the treatment of cerumen impaction?

Removal of the wax usually causes immediate relief.  There are a variety of ways to do this, including sucking out the wax with a vacuum, removing it with a loop, and flushing it out.  These should be done by a medical professional, since injury to the ear canal and ear drum can result if not done properly.  Ear candling is not recommended for removal of wax, since this can lead to burns.

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To find a head and neck specialist for your needs, contact the Head & Neck Institute at 216.444.8500 (or toll-free 1.800.223.2273, ext. 48500)

This information is provided by Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.

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