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Comparative effects of snoring sound between two minimally invasive surgeries in the treatment of snoring: a randomized controlled trial.

Lee LA, Yu JF, Lo YL, Chen NH, Fang TJ, Huang CG, Cheng WN, Li HY - PLoS ONE (2014)

Bottom Line: The VAS and snore outcomes survey scores were significantly improved in both groups.In addition, the snoring index was significantly reduced in the radiofrequency group.Multi-stage radiofrequency surgery was not tested.

View Article: PubMed Central - PubMed

Affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital at Linkou, School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan, R.O.C.; Sleep Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan, R.O.C.; Department of Otolaryngology, Xiamen Chang Gung Hospital, Xiamen, Fujian Province, China.

ABSTRACT

Background: Minimally invasive surgeries of the soft palate have emerged as a less-invasive treatment for habitual snoring. To date, there is only limited information available comparing the effects of snoring sound between different minimally invasive surgeries in the treatment of habitual snoring.

Objective: To compare the efficacy of palatal implant and radiofrequency surgery, in the reduction of snoring through subjective evaluation of snoring and objective snoring sound analysis.

Patients and method: Thirty patients with habitual snoring due to palatal obstruction (apnea-hypopnea index ≤15, body max index ≤30) were prospectively enrolled and randomized to undergo a single session of palatal implant or temperature-controlled radiofrequency surgery of the soft palate under local anesthesia. Snoring was primarily evaluated by the patient with a 10 cm visual analogue scale (VAS) at baseline and at a 3-month follow-up visit and the change in VAS was the primary outcome. Moreover, life qualities, measured by snore outcomes survey, and full-night snoring sounds, analyzed by a sound analytic program (Snore Map), were also investigated at the same time.

Results: Twenty-eight patients completed the study; 14 received palatal implant surgery and 14 underwent radiofrequency surgery. The VAS and snore outcomes survey scores were significantly improved in both groups. However, the good response (postoperative VAS ≤3 or postoperative VAS ≤5 plus snore outcomes survey score ≥60) rate of the palatal implant group was significantly higher than that of the radiofrequency group (79% vs. 29%, P = 0.021). The maximal loudness of low-frequency (40-300 Hz) snores was reduced significantly in the palatal implant group. In addition, the snoring index was significantly reduced in the radiofrequency group.

Conclusions: Both palatal implants and a single-stage radiofrequency surgery improve subjective snoring outcomes, but palatal implants have a greater effect on most measures of subjective and objective snoring. Multi-stage radiofrequency surgery was not tested.

Trial registration: ClinicalTrials.gov NCT01955083.

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Related in: MedlinePlus

Favorable anatomy for the MIS of the soft palate in anti-snoring treatment.(A) Frontal view showing the longitudinal length from the uvular base to the hard palate-soft palate junction ≥ 2.5 cm and the lateral width of the uvular base ≥ 1.0 cm. (B) Lateral view illustrating the anterior-posterior width of the uvular base ≥ 1.0 cm.
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pone-0097186-g002: Favorable anatomy for the MIS of the soft palate in anti-snoring treatment.(A) Frontal view showing the longitudinal length from the uvular base to the hard palate-soft palate junction ≥ 2.5 cm and the lateral width of the uvular base ≥ 1.0 cm. (B) Lateral view illustrating the anterior-posterior width of the uvular base ≥ 1.0 cm.

Mentions: The inclusion criteria were: a) age, 18–60 years; b) body mass index, ≤30 kg/m2; c) length of the soft palate (from the uvula base to the hard palate-soft palate junction) ≥2.5 cm and the width of the base of the uvular ≥1.0 cm (Figure 2). These criteria were basically in accordance with the criteria for a PI procedure as described in the literature [6], [9], [11], [16]. Patients were excluded if they had tonsillar hypertrophy (tonsil size ≥3), high tongue position (Friedman tongue position ≥4), retrognathia, craniofacial abnormalities, trismus, allergy to anesthetic or poorly controlled medical disorders such as hypertension, bleeding tendency, cardiovascular disorder, and stroke. Four patients were excluded due to ‘Not meeting inclusion criteria (n = 3)’ and ‘Declined to participate (n = 1)’.


Comparative effects of snoring sound between two minimally invasive surgeries in the treatment of snoring: a randomized controlled trial.

Lee LA, Yu JF, Lo YL, Chen NH, Fang TJ, Huang CG, Cheng WN, Li HY - PLoS ONE (2014)

Favorable anatomy for the MIS of the soft palate in anti-snoring treatment.(A) Frontal view showing the longitudinal length from the uvular base to the hard palate-soft palate junction ≥ 2.5 cm and the lateral width of the uvular base ≥ 1.0 cm. (B) Lateral view illustrating the anterior-posterior width of the uvular base ≥ 1.0 cm.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4016275&req=5

pone-0097186-g002: Favorable anatomy for the MIS of the soft palate in anti-snoring treatment.(A) Frontal view showing the longitudinal length from the uvular base to the hard palate-soft palate junction ≥ 2.5 cm and the lateral width of the uvular base ≥ 1.0 cm. (B) Lateral view illustrating the anterior-posterior width of the uvular base ≥ 1.0 cm.
Mentions: The inclusion criteria were: a) age, 18–60 years; b) body mass index, ≤30 kg/m2; c) length of the soft palate (from the uvula base to the hard palate-soft palate junction) ≥2.5 cm and the width of the base of the uvular ≥1.0 cm (Figure 2). These criteria were basically in accordance with the criteria for a PI procedure as described in the literature [6], [9], [11], [16]. Patients were excluded if they had tonsillar hypertrophy (tonsil size ≥3), high tongue position (Friedman tongue position ≥4), retrognathia, craniofacial abnormalities, trismus, allergy to anesthetic or poorly controlled medical disorders such as hypertension, bleeding tendency, cardiovascular disorder, and stroke. Four patients were excluded due to ‘Not meeting inclusion criteria (n = 3)’ and ‘Declined to participate (n = 1)’.

Bottom Line: The VAS and snore outcomes survey scores were significantly improved in both groups.In addition, the snoring index was significantly reduced in the radiofrequency group.Multi-stage radiofrequency surgery was not tested.

View Article: PubMed Central - PubMed

Affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital at Linkou, School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan, R.O.C.; Sleep Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan, R.O.C.; Department of Otolaryngology, Xiamen Chang Gung Hospital, Xiamen, Fujian Province, China.

ABSTRACT

Background: Minimally invasive surgeries of the soft palate have emerged as a less-invasive treatment for habitual snoring. To date, there is only limited information available comparing the effects of snoring sound between different minimally invasive surgeries in the treatment of habitual snoring.

Objective: To compare the efficacy of palatal implant and radiofrequency surgery, in the reduction of snoring through subjective evaluation of snoring and objective snoring sound analysis.

Patients and method: Thirty patients with habitual snoring due to palatal obstruction (apnea-hypopnea index ≤15, body max index ≤30) were prospectively enrolled and randomized to undergo a single session of palatal implant or temperature-controlled radiofrequency surgery of the soft palate under local anesthesia. Snoring was primarily evaluated by the patient with a 10 cm visual analogue scale (VAS) at baseline and at a 3-month follow-up visit and the change in VAS was the primary outcome. Moreover, life qualities, measured by snore outcomes survey, and full-night snoring sounds, analyzed by a sound analytic program (Snore Map), were also investigated at the same time.

Results: Twenty-eight patients completed the study; 14 received palatal implant surgery and 14 underwent radiofrequency surgery. The VAS and snore outcomes survey scores were significantly improved in both groups. However, the good response (postoperative VAS ≤3 or postoperative VAS ≤5 plus snore outcomes survey score ≥60) rate of the palatal implant group was significantly higher than that of the radiofrequency group (79% vs. 29%, P = 0.021). The maximal loudness of low-frequency (40-300 Hz) snores was reduced significantly in the palatal implant group. In addition, the snoring index was significantly reduced in the radiofrequency group.

Conclusions: Both palatal implants and a single-stage radiofrequency surgery improve subjective snoring outcomes, but palatal implants have a greater effect on most measures of subjective and objective snoring. Multi-stage radiofrequency surgery was not tested.

Trial registration: ClinicalTrials.gov NCT01955083.

Show MeSH
Related in: MedlinePlus