Efficacy of the pillar implant in the treatment of snoring and mild-to-moderate obstructive sleep apnea: A meta-analysis

초록

Objectives/Hypothesis: The Pillar implant is one of the surgical options for snoring and obstructive sleep apnea (OSA). It is designed to be inserted into the soft palate to reduce vibration and collapsibility. The efficacy of the Pillar implant has been evaluated in various studies. However, only one study conducted a meta-analysis of the findings, and was based on only three studies. We tried to get a more definite conclusion on the efficacy of the Pillar implant. Study Design: Meta-analysis. Methods: Efficacies were analyzed separately, one for snoring and the other for mild-to-moderate OSA. We searched MEDLINE, LILACS, SCOPUS, and the Cochrane Library. The key words snoring AND implants were used for snoring, and apnea AND implants for OSA. Seven studies for snoring and seven studies for mild-to-moderate OSA were finally included for meta-analysis. For snoring patients, a visual analogue scale that is scored by the bed partner was used to evaluate the loudness of the snoring sound. Results: The Pillar implant reduced snoring sound significantly (standardized mean difference [SMD], -0.591; 95% confidence interval [CI], -0.753 to -0.429, P < .001). For mild-to-moderate OSA patients, the Pillar implant significantly reduced the Epworth Sleepiness Scale (SMD, -0.481; 95% CI, -0.606 to -0.358, P < .001), and apnea-hypopnea index (SMD, -0.378; 95% CI, -0.619 to -0.138, P = .002). Mean extrusion rate was 9.3% (95% CI, 7.0 to 12.2%). Conclusions: The present results indicate that the Pillar implant has a moderate effect on snoring and mild-to-moderate OSA. However, we need more studies with high level of evidence to arrive at a definite conclusion. Laryngoscope, 2013

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