NightLase®: Minimally Invasive Laser-Assisted Uvulopalatoplasty

Dr. Harvey S. Shiffman DDS, Dr. Matjaz Lukac

There are a multitude of treatment options for sleep-disordered breathing (SDB), which can be classified into conservative, apparatus and surgical methods. The choice of the method used will depend on the patient’s tolerance of the procedure, and most importantly, on the severity of the patient’s SDB.

Laser-assisted uvulopalatoplasty (LAUP) belongs to the surgical category and is therefore commonly associated with a higher severity of treatment. However, the severity depends on the LAUP approach used. The LAUP method, which was originally introduced as a variant of the standard and relatively invasive surgical uvulopalatopharyngoplasty (UPPP) method, was modified in the early 90’s to address mainly palatal flutter, which was found to be the most important factor in the mechanism of snoring. Therefore, instead of surgically shortening the palate as in UPPP, which inevitably risks impairing its function, the LAUP approach focuses on stiffening and shrinking of the palatal tissue. This is accomplished by thermally injuring the surface of the soft palate, which heals by fibrosis and/or collagen shrinkage and neocollagenesis, thus producing the desired shortening and stiffening. When performed at sub-ablative laser fluences, this type of LAUP is a “walk-in, walk out” procedure that typically does not require any anesthesia.

In this paper, clinical experience is reported on the use of an Nd:YAG/Er:YAG dental laser system to perform the LAUP procedure to reduce symptoms of sleep-disordered breathing.

NightLase®: Minimally Invasive Laser-Assisted Uvulopalatoplasty