Awake “Double-W” barbed palatoplasty for snoring: a pilot study

Introduction: Sleep-related breathing disorders, like primary snoring, are common in adults and have significant clinical and social implications. Although often considered benign, snoring can lead to fragmented sleep, daytime sleepiness, and decreased quality of life for both patients and their partners. It may also indicate obstructive sleep apnea. Minimally invasive procedures under local anesthesia are attractive for managing snoring, potentially reducing reliance on chronic devices. This study evaluates the safety, tolerability, and efficacy of minimally invasive, awake “Double-W” barbed palatoplasty for snoring. Methods: From October 2024 to April 2025, 15 adult patients with habitual snoring were enrolled. Subjects with apnea-hypopnea index > 14, minimum oxygen saturation < 85%, or BMI > 32 were excluded. Outcomes were evaluated by comparing pre and post-operative (90–180 days) bed partner assessed snoring VAS (sVAS) scores and a simplified Snoring Questionnaire. Pain and surgical tolerability were evaluated by intraoperative VAS (iVAS) scores. Results: Ten males and five females (mean age 57.2 ± 15.9, BMI 26.2 ± 2.0) were enrolled. Double-W barbed palatoplasty significantly reduced snoring scores from 8.15 ± 1.21 to 3.2 ± 1.61 (p < 0.05), improving snoring frequency and bed partner tolerance. The procedure was well tolerated with an average iVAS pain score of 2.76 ± 1.61. No serious adverse events were recorded, and all patients were discharged within 6 h. Conclusion: Awake double-W palatoplasty appears safe and well tolerated in selected snorers. It is minimally invasive, incisionless, and repeatable, with potential for use in multistage strategies for snoring or sleep apnea.