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Minding the Snore

February 21, 2006

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RATING:

"IF snoring is forcing you and your sweetheart to sleep in separate rooms, it may be time to take action. And increasingly, that action is surgery. The Pillar procedure is a new treatment for snoring and, though technically surgery, it takes no more than an hour at the doctor's office. Local specialist Dr. Charles Kimmelman, associate professor at the Weill Cornell College of Medicine and chief of smell and taste disorders at Manhattan Eye, Ear & Throat Hospital, says 81 percent of patients who've undergone the Pillar procedure have reported a reduction in snoring. "

Our Review Summary

This story discussed the Pillar Procedure for snoring, which involves the insertion of three one-inch inserts into the palate to help reduce the vibration that causes snoring. The procedure is reportedly less invasive than other surgeries, reducing snoring in many patients and requiring less time for recovery with fewer complications. The journalist here notes the cost of the surgery is $2,500, however, this is followed by a patient quote that "it's worth it", which affects the balance of the story. There is no mention of how the cost compares to other treatments that were mentioned earlier in the article. Also, it is unclear if this is the cost for the procedure visit only; are the "antibiotics and few checkups down the road" included or not? While this story provides a decent overview of a newer treatment for snoring, there is no quantitative evidence that the Pillar Procedure is more or less effective than other surgeries for snoring. Only patient testimonials and anecdotal evidence are used to promote the Pillar Procedure, and we do not have any information on long-term follow-up. 81% of people treated reported a reduction in snoring, but we do not know if that was after 1 week, 1 month, or 1 year, etc. We are simply told "for long-term help, the Pillar procedure appears most promising." The journalist mentions alternatives to the Pillar Procedure, including both surgical and non-surgical treatments for snoring, such as injections, dental devices, the C-PAP machine and home remedies, yet there are inappropriate statements and hyperbole to describe the alternatives, such as: "other snore remedies have similar baggage, some are downright painful" or surgery for other treatments is "exhaustive". There is also no quantitative comparison between the effectiveness of the Pillar with these other treatments. What is also not considered here is that no treatment is also an option. Snoring is not bothersome for many people or their bedmates, therefore, interventions to treat snoring are not always necessary. The surgical procedure may be "like going to the dentist", but this does not estimate risks of an outpatient surgical procedure. The journalist provides little data on the incidence of side effects with this surgery, only that there are no major complications reported. There is a mention of a 1% harm of extrusion, or the body rejecting the cylinders, but again, there is no context for this figure. Additionally, short-term side effects are described as a feeling of "pizza burn on roof of mouth", but this minimizes the discomfort. Lastly, there is no disclaimer of conflict of interest, so we cannot determine from the article if Dr. Kimmelman, proponent of Pillar and the medical expert cited, has financial interest in or funding from Restore Medical, maker of the Pillar devices.


 

Click on Criteria for definitions.

Story does not mention where this treatment is available and if it is widespread.

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Discuss costs? - NOT SATISFACTORY

Provides cost estimate for the surgery as $2,500, however, this is followed by a patient quote that "it's worth it." This is imbalanced. There's no mention of how the cost compares to other treatments that were mentioned earlier in the article. Also, unclear if this is the procedure visit only; are the "antibiotics and few checkups down the road" included or not.

No clear evidence of disease mongering. However, snoring is not an bothersome issue for some people, therefore, interventions are not always necessary.

No real evidence that the Pillar procedure is more or less effective that more traditional methods. Cited statistics not meaningful. 81% of patients may say it is helpful at reducing snoring, but we need to know more on the origins of this figure. Was this from a controlled study? Company testing? Reports from surgeons or sleep specialists? When the story says "most people experience a significant benefit from Pillar, " what does that mean?

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Mentions 1% harm of extrusion, or the body rejecting the cylinders, but gives no quantitative context for this figure. How many people have used the Pillar and had extrusion or partial extrusion? There is also no evidence of other side effects from clinical studies, only that there are no major complications reported. If 81% of people found it effective, 19% did not. We need to know why the Pillar might not be effective for those people and what are the risks of the procedure. It may be "like going to the dentist", but this does not estimate risks of an outpatient surgical procedure. Additionally, short-term side effects are described as a feeling of "pizza burn on roof of mouth" but this minimizes the discomfort. The story doesn't explain why antibiotics are given. The story doesn't explain why a "few checkups down the road" are needed, what happens or how much they cost. The "few checkups" might be an inconvenience for many people.

Mentions FDA approval for this surgery/device in 2004 for adults.

See above. Only patients testimonials and anecdotal evidence in this story. No data to justify claims in the story and we don't know if people benefit from the Pillar in the short or long term.

We can't be sure if the story relied solely on a news release.

It cannot be determined from the articles if Dr. Kimmelman, the proponent of Pillar and the medical expert cited, has financial interest in or funding from Restore Medical, maker of the Pillar devices. Did the journalist ask?

Satisfactorily mentions other treatments for snoring and sleep apnea, including other surgeries, injections, dental devices, the C-PAP machine and home remedies, such as sleeping on tennis balls. There is no quantitative comparison of the effectiveness of the Pillar with other treatments in controlled studies. There is no balanced information about the alternatives. It's not balanced to criticize alternatives for their temporary effectiveness when we do not have any information on long term follow-up of the Pillar. Regarding the 81% who reported a reduction in snoring, the story does not make clear if that was after 1 week, 1 month, or 1 year, etc. It is not balanced to describe the alternatives, such as: "other snore remedies have similar baggage, some are downright painful", while minimizing the sore throat and the pizza burn sensation with the Pillar. Hyperbole is used in describing surgical alternatives: "...ALL are painful and require a week or two of EXHAUSTIVE recovery."

Total Score: 2 of 9 Satisfactory

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