Me and my operation: A metal triangle up my nose silenced my snores
22:52 GMT, 12 March 2012
Millions of Britons snore or are affected by a partner’s night-time snuffles. Sharon Esiroglu, 49, who owns a restaurant in Upminster, Essex, had a new procedure to tackle her snoring, as she tells CAROL DAVIS.
Sleeping silently: Sharon Esiroglu
Around eight years ago, I started feeling bunged up all the time, as though I had a cold or flu that wouldn’t go away. My GP said I probably had some kind of allergy, and gave me a nasal spray and antihistamine tablets, but they didn’t really help.
My symptoms were getting worse — I’d feel bunged up all night and sometimes wake with a start, feeling that I couldn’t breathe. My husband, Yildirim, told me I’d started snoring, which was embarrassing.
I put up with this for four years — and then I started getting headaches and painful infections in my left ear. My GP kept giving me antibiotics, but the infections were getting me down. I was also just so tired all the time.
Finally, I had enough and decided to pay to see a private ear, nose and throat specialist, George Fayad, two years ago. He sent me for X-rays, which showed that the left side of my nose was blocked. I have a small nose and Mr Fayad explained that as I’d got older the cartilage — particularly a valve at the top of the nose — had started to sag. He said it was pretty common, in the same way as other body parts sag as you get older.
I also had a deviated septum, where the cartilage that separates your nostrils is crooked, and this wasn’t helping things. This all meant I was having breathing problems. I was snoring because, as I breathed in, the sagging cartilage and valve were partly collapsing inwards, blocking the airway.
Mr Fayad said the ear infections could be connected, too, because the ear, nose and throat are all linked, and the tubes need air to keep them clear. He mentioned he was pioneering an operation where he’d put a tiny metal implant into my nose to make it rigid. I wouldn’t feel it, but it would stop the cartilage collapsing when I breathed.
He said he’d also straighten my septum by taking away some bone and cartilage to keep my airways clear. It sounded great. First, I had to try special nasal strips that you stick across the widest part of the nose to pull open the nostrils. They were a nuisance to stick on every night, but they worked, which confirmed that the problem was an obstruction in my nostrils. This suggested the implant would work, too.
I had the operation a few months later under a general anaesthetic — the op took about 45 minutes and I stayed in hospital overnight. I went home the next day with a bandage on my nose. My nose felt bunged up because it was packed with a special dressing. I had to take it easy for two weeks, but after that I could breathe clearly again. The difference is amazing — I don’t feel bunged up, my sense of smell has improved and Yildirim tells me I don’t snore any more, which is wonderful.
Snoring can disrupt sleep and make us feel tired and unwell the next day
George Fayad is a consultant ear, nose and throat surgeon at Basildon University Hospital and Spire Hospital Hartswood. He says:
About 40 per cent of Britons snore, and the problem is made worse when we are overweight, as we age and after drinking alcohol and eating a heavy meal. As well as disturbing everyone around us, snoring can disrupt sleep and make us feel tired and unwell the next day.
There are many causes of snoring, including vibration and flutter of the uvula, a flap of soft tissue hanging at the back of the mouth. But about 40 per cent of adults have some kind of nasal collapse when they breathe in hard.
This affects the nasal valve, which
is the narrowest part of the nose below the bony bridge. Its role is to
regulate the amount of air going in and out of the nose. The valve itself looks like two upside down V-shapes of cartilage, one over the other (like the Citroen car logo).
In some people, however, the nasal valve partly collapses inwards towards the septum (the wall dividing the nose).
Significant nasal collapse can close off the airways, disrupting
breathing. As a result, when the person breathes, the air is forced
through a smaller gap, which causes the snoring sound.
This problem can be genetic, when people have a high and narrow nose; caused by an accident; or be the result of surgery on the nose. It also gets worse as we age because the soft tissue of the nose and the nasal valve loses stiffness and everything starts to sag, and so it starts to collapse.
Some people also have a crooked septum, which further narrows airways, so when cartilage starts to collapse, this can become a problem. And lifestyle changes can help — losing weight means the patient needs less oxygen for their body mass.
12 per cent of British couples who sleep apart every night because of snoring
They will be advised to avoid smoking,
heavy meals and alcohol before bedtime because these cause the muscles
and airway to relax. Patients
can also use nasal strips at night, which go across the nose and pull
the soft tissue open over the nasal valve, keeping the airways open.
When all else fails and the patient’s breathing and sleep are seriously
disrupted, we can offer surgery.
The traditional method has involved taking some cartilage from the earlobe to reshape the nasal valve. However, it’s very fiddly, and doesn’t always work because adding tissue to the area means you’re at risk of blocking the airway further. The Breathe-Implant was invented by a Swiss surgeon in 2003 and I introduced it to Britain in 2009.
It’s basically a V-shaped piece of titanium just 0.5 mm in width and with holes so it is extremely light. Sliding this V-shape between the two V-shaped layers of cartilage keeps them open permanently and stops them collapsing, but does not change the shape of the nose.
The operation takes about 45 minutes under general anaesthetic. First, I make a 1-2cm incision at the top of the nose and dissect the two layers of cartilage away from each other, to make space for the implant. Then I carefully slide the implant into place, stitching it securely to the cartilage, and close the wound with dissolvable stitches. In Sharon’s case, I also straightened the septum, removing some cartilage and bone to shorten and straighten it, and moving it back to the middle of the nose.
Then I pack the nose with dissolvable padding, to absorb bleeding and prevent infection — the padding will gradually dissolve over a week or two, so will not need removing, and the patient will be able to breathe normally. This is a fantastic operation that improves breathing and often the sense of smell, too, and prevents more sleep and snoring problems by keeping the airways open and improving flow. Best of all, it’s permanent, so should solve the problem for good.
The operation costs 3,400 privately — it is a similar cost to the NHS — and is available at a few centres across the country.