Abstract
The purpose of this study was to evaluate the efficiency of radiofrequency tissue volume reduction (RFTVR) and uvulopalatopharyngoplasty (UPPP) in the treatment of snoring in a prospective clinical trial of 79 patients consecutively undergoing surgery for snoring. Seventy-nine patients with primary snoring or mild OSAS (obstructive sleep apnea syndrome) were enrolled in this clinical trial (66 males and 13 females). According to the anatomical findings (the size of the tonsils and uvula), the patients underwent UPPP/TE of the RFTVR of the soft palate. Forty-seven patients had UPPP/TE (age 45.81±12.11 years; median AHI: 8; range 1–29). Thirty-two patients were treated with RFTVR of the soft palate (age 48.10±10.92; median AHI: 5.0; range 0–26). The average number of treatments was 2.2. All patients underwent preoperative polysomnography to exclude severe OSAS. Pre- and postoperative snoring scores were evaluated from the patients with bed partners. Postoperative follow-up data were collected at a median of 4 months after treatment; 85.1% of the UPPP group and 53.1% of the RFTVR group underwent postoperative polysomnography. Subjective snoring scores of all study participants were evaluated. Preoperatively, there was no statistically significant difference of subjective symptoms, age and BMI between the two groups. The snoring scores improved statistically significantly in both groups ( P <0.001 in the UPPP group; P =0.001 in the RFTVR group). After UPPP/TE snoring improved in 37 patients (78.7%), and 29 (61.7%) thereof were free of bothersome snoring; no change was found in 9 patients (19.2%), and 1 (2.1%) worsened. In the RFTVR group, snoring improved in 15 (46.9%), and 9 (28.1%) thereof were free of bothersome snoring; no change was found in 13 patients (50%), and 1 worsened (3.1%). Preoperative AHI was statistically higher ( P =0.016) and mean minimal oxygen saturation significantly lower ( P =0.002) in the UPPP group. In the UPPP group AHI and HI showed statistically significant improvement postoperatively ( P =0.025 and P =0.034, respectively). After RFTVR, no statistically significant change of AHI, HI or oxygen saturation was found. Besides limited mucosal erosions (15%) after RFTVR and foreign body sensations (<10%) after UPPP/TE, no side effects were observed. The success rate of RFTVR of the soft palate is lower compared to the more invasive technique of UPPP. Due to its minimally invasive character, RFTVR is suitable as first-step treatment for snoring, but patients should be counseled about possible success rates and different treatment options.
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References
Blumen MB, Dahan S, Fleury B, Hauuser Hauw C, Chabolle F (2002) Radiofrequency ablation for the treatment of mild to moderate obstructive sleep apnoea. Laryngoscope 112:2086–2092
Boudewyns A, van de Heyning P (2000) Temperature controlled tissue volume reduction of the soft palate (Somnus) in the treatment of habitual snoring: results of an European multicenter trial. Acta Otolaryngol 120:981–985
Emery BE, Flexon PB (2000) Radiofrequency tissue volume reduction of the soft palate: a new treatment for snoring. Laryngoscope 110:1092–1098
Fischer Y, Khan M, Mann W (2003) Multilevel temperature controlled radiofrequency therapy of soft palate, base of tongue and tonsils in adults with obstructive sleep apnoea. Laryngoscope 113:1786–1791
Fitzpatrick MF, Martin K, Fossey E, Shapiro CM, Elton RA, Douglas NJ (1993) Snoring, asthma and sleep disturbance in Britain: a community based survey. Eur Resp 6:531–535
Friberg D, Carlsson-Nordlander B, Larsson H, Svanborg E. (1995) UPPP for habitual snoring: A 5-year follow-up with respiratory sleep recordings. Laryngoscope 105:519–522
Fujita S, Conway WA, Zorick R (1985) Evaluation of the effectiveness of the uvulopalatopharyngoplasty. Laryngoscope 95:70–74
Gislason T, Aberg H, Taube A (1987) Snoring and systemic hypertension—an epidemiologic study. Acta Med Scand 222:415–421
Hessel N, de Vries N (2003) Results of uvulopalatopharyngoplasty after diagnostic work up with polysomnography and sleep endoscopy: a report of 136 snoring patients. Eur Arch Otorhinolaryngol 260:91–95
Hukins C, Mitchel I, Hilman D (2000) Radiofrequency tissue volume reduction of the soft palate in simple snoring. Arch Otolaryngol Head Neck Surg 126:602–606
Ikematsu T (1964) Study of snoring, IV: therapy. J Jpn Oto-Rhinol Laryngol 64: 221–224
Kamami YV (1990) Laser CO2 for snoring—preliminary results. Acta Otorhinolaryngol Belg 44:451–456
Koskenvuo M, Kaprio J, Partinen M (1985) Snoring as a risk factor for hypertension and angina pectoris. Lancet 893–896
Norton P, Dunn E (1985) Snoring as a risk factor for disease: an epidemiological survey. Br Med 291:630–632
Osman EZ, Osborne JE, Hill PD, Lee B, Hammad Z (2000) Uvulopalatopharyngoplasty versus laser assisted uvuloplasty for the treatment of snoring: an objective randomized clinical trial. Clin Otolaryngol All Sci 25:305–310
Powell NB, Riley RW, Guilleminaut C et al (1998) Radiofrequency volumetric tissue reduction of the palate in subjects With sleep-disordered breathing. Chest 113:1163–1173
Schmidt-Nowara WW, Coultas DB, Wiggins CL, Skipper BE, Samet JM (1988) Prevalence and snoring in an adult population. Chron Rhonchopath 135–140
Seppäla T, Partinen M, Penttilä A, Aspholm R, Tiainen E (1991) Sudden death and sleeping history among Finnish men. J Int Med 229:23–28
Sher A, Flexon B, Hillman D, Emery B, Swieca J, Smith T et al (2001) Temperature controlled radiofrequency tissue volume reduction in the human soft palate. Otolaryngol Head Neck Surg 124:312–318
Terris T, Coker J, Thomas A, Chavoya M (2002) Preliminary findings from a prospective, randomized trial of two palatal operations for sleep disordered breathing. Otolaryngol Head Neck Surg 127:315–323
Woodson BT, Steward DL, Weaver EM, Javaheri S (2003) A randomized trial of temperature controlled radiofrequency, continuous airway pressure and placebo for obstructive sleep apnoea syndrome. Otolaryngol Head Neck Surg 128:848–861
Young T, Palta M, Dempsea J, Skatrud J, Weber S, Badr S (1993) Occurrence of sleep disordered breathing among middle-aged adults. N Engl J Med 328:1230–1235
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Hofmann, T., Schwantzer, G., Reckenzaun, E. et al. Radiofrequency tissue volume reduction of the soft palate and UPPP in the treatment of snoring. Eur Arch Otorhinolaryngol 263, 164–170 (2006). https://doi.org/10.1007/s00405-005-0959-5
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DOI: https://doi.org/10.1007/s00405-005-0959-5