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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

Radiofrequency surgery.(A) Preoperative frontal view illustrating the 3 operative sites of the soft palate (1.0 cm below the hard palate-soft palate junction; 1.0 cm between the midline and para-midline sites). (B) Postoperative frontal view demonstrating the stiffened zone (grey zone) by the RF energy (1.0 cm×2.6 cm).
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pone-0097186-g004: Radiofrequency surgery.(A) Preoperative frontal view illustrating the 3 operative sites of the soft palate (1.0 cm below the hard palate-soft palate junction; 1.0 cm between the midline and para-midline sites). (B) Postoperative frontal view demonstrating the stiffened zone (grey zone) by the RF energy (1.0 cm×2.6 cm).

Mentions: RF energy was delivered via a generator (Somnus Model S2, Gyrus-ACMI Corporation, Maple Grove, MN, USA) with the power set to 10 watts and the maximal target temperature to 85°C. The needle electrode was inserted through the mucosa into the muscle layer at the entry points (approximately 1 cm below the hard palate-soft palate junction). The electrode was kept in place until 600 J had been delivered at the midline and 300 J at both para-midline sites (approximately 1 cm horizontal distance; Figure 4) [13], [27].


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)

Radiofrequency surgery.(A) Preoperative frontal view illustrating the 3 operative sites of the soft palate (1.0 cm below the hard palate-soft palate junction; 1.0 cm between the midline and para-midline sites). (B) Postoperative frontal view demonstrating the stiffened zone (grey zone) by the RF energy (1.0 cm×2.6 cm).
© Copyright Policy
Related In: Results  -  Collection

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

pone-0097186-g004: Radiofrequency surgery.(A) Preoperative frontal view illustrating the 3 operative sites of the soft palate (1.0 cm below the hard palate-soft palate junction; 1.0 cm between the midline and para-midline sites). (B) Postoperative frontal view demonstrating the stiffened zone (grey zone) by the RF energy (1.0 cm×2.6 cm).
Mentions: RF energy was delivered via a generator (Somnus Model S2, Gyrus-ACMI Corporation, Maple Grove, MN, USA) with the power set to 10 watts and the maximal target temperature to 85°C. The needle electrode was inserted through the mucosa into the muscle layer at the entry points (approximately 1 cm below the hard palate-soft palate junction). The electrode was kept in place until 600 J had been delivered at the midline and 300 J at both para-midline sites (approximately 1 cm horizontal distance; Figure 4) [13], [27].

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