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Radiofrequency Tissue Volume Reduction of the Soft Palate in Simple Snoring

2000; American Medical Association; Volume: 126; Issue: 5 Linguagem: Inglês

10.1001/archotol.126.5.602

1538-361X

Craig Hukins, Ian C. Mitchell, David R. Hillman,

Neuroscience of respiration and sleep

Background Snoring is common and often associated with social morbidity. Current therapies are generally unsatisfactory, but radiofrequency tissue volume reduction (RFTVR) palatoplasty offers a new approach. Objective To assess the outcomes and morbidity associated with RFTVR palatoplasty. Design Open, prospective trial. Setting Tertiary referral center. Patients 20 adults with loud habitual snoring without clinically significant obstructive sleep apnea. Interventions Three treatments with RFTVR to the middle, distal, and proximal thirds of the midline of the soft palate. Main Outcome Measures Clinical assessment (visual analog scores) before and after each treatment, polysomnography (with sound intensity measurements), and lateral cephalometry performed prior to the first treatment and 2 months following the final treatments. Results After treatment, there was a significant overall improvement in the snoring visual analog score (7.5 ± 1.5 to 4.6 ± 2.5; P <.001), a small reduction in the proportion of sleep spent snoring at 50 to 60 dB ( P =.03), and mild pain that was controlled with simple analgesia. There were no long-term adverse effects. Individual response could not be predicted by demographic, polysomnographic, or cephalometric data. Treatment of the proximal third of the soft palate was associated with fewer adverse effects but also seemed less effective than at the other sites. Conclusions (1) The RFTVR palatoplasty is well tolerated with very low morbidity. (2) It is associated with subjective improvement in snoring in most patients. (3) Placement of lesions seems to influence outcome. (4) The improvement is accompanied by a marginal change in objective measurements, suggesting either an acoustic change independent of sound intensity or a placebo effect. (5) A randomized controlled trial is needed to further evaluate this therapy.