以非溫控式射頻縮減軟腭體積治療打鼾

Treatment of Snoring with Non-Temperature-Controlled Radiofrequency Tissue Volume Reduction of the Soft Palate

劉博仁(Po-Jen Liu)

《中華民國耳鼻喉科醫學雜誌》 37卷4期 (2002/06) Pp. 271-278

https://doi.org/10.6286/2002.37.4.271

摘要

BACKGROUND: Snoring is common in the adult population and is often associated with social morbidity. Two of the most common surgical treatments are uvulopalatopharyngop-lasty (UPPP) and laser-assisted-uvulopalatoplasty (LAUP). Recently, temperature-controlled radiofrequency tissue volume reduction (RFTVR) palatoplasty offers a new approach. This study investigated the outcomes and morbidity associated with non-temperature RFTVR of the soft palate for the treatment of snoring.
METHOD: Between July 2000 and February 2001, 18 patients, (15men) with a mean age of 39.25 ± 11.806 years, who sought treatment for socially disruptive snoring were included in this study. These patients all met the inclusion criteria of: a respiratory distur-bance index ≦ 15 and a saturation nadir ≧ 85%. Radiofrequency energy was delivered to the submucosa of the soft palate through a specially designed needle electrode (penetrate-ing depth was 5 mm), and with a predetermined 7 wattage and average treatment time 196 seconds. Repeated radiofrequency with a two month interval will be done if patient was unsatisfied, and the applied energy was 7 wattage and decrease treatment time to 105 seconds. Clinical snoring assessment (visual analog scores, VAS) was subjectively assessed by patients’ family 2 months later after each treatment. The VAS score ≦ 3 after treatment and a decrease in VAS score of ≧ 5 were considered to indicate a successful result.
RESULTS: A total of 37 treatments were given to the 18 patients. The mean number of treatments given to each patient was 2.055 ± 0.725. After the ending treatment, there was a significant overall improvement in the snoring VAS score (7.611 ± 1.539 to 3.278 ± 2.296). Six patients (33.33%) after the first treatment and thirteen patients (72.22%) after the whole course treatment met the criteria of VAS ≦ 3. Nine patients (50%) had a decrease in VAS score by 5 or more after the whole course of treatment. The successful rate was 83.33%. Two patients developed mild airway compromise within 12 hours which may have been due to soft palate edema. In 37 treatments, post procedural pain was controlled with oral acetaminophen within 24 hours in 11 treatments (29.73%) and after the second 24 hours in 3 treatments (8.11%). One patient developed soft palate perfora-tion after the second treatment. One patient suffered from lump sensation after the second treatment. No pre-existing speech problems were adversely affected.
CONCLUSION: Non-temperature-controlled radiofrequency tissue volume reduction of the soft palate offers an alternative approach for the treatment of snoring. Our results indi-cate that it is associated with subjective improvement in snoring in most patients. It also appears to be safer, better-tolerated, to cause less postoperative pain and lower postopera-tive morbidity, to be more amenable to retreatment, and to have a lower procedural cost compared to laser and temperature-controlled RFTVR.

關鍵字

射頻 ； 打鼾

並列摘要

BACKGROUND: Snoring is common in the adult population and is often associated with social morbidity. Two of the most common surgical treatments are uvulopalatopharyngop-lasty (UPPP) and laser-assisted-uvulopalatoplasty (LAUP). Recently, temperature-controlled radiofrequency tissue volume reduction (RFTVR) palatoplasty offers a new approach. This study investigated the outcomes and morbidity associated with non-temperature RFTVR of the soft palate for the treatment of snoring.
METHOD: Between July 2000 and February 2001, 18 patients, (15men) with a mean age of 39.25 ± 11.806 years, who sought treatment for socially disruptive snoring were included in this study. These patients all met the inclusion criteria of: a respiratory distur-bance index ≦ 15 and a saturation nadir ≧ 85%. Radiofrequency energy was delivered to the submucosa of the soft palate through a specially designed needle electrode (penetrate-ing depth was 5 mm), and with a predetermined 7 wattage and average treatment time 196 seconds. Repeated radiofrequency with a two month interval will be done if patient was unsatisfied, and the applied energy was 7 wattage and decrease treatment time to 105 seconds. Clinical snoring assessment (visual analog scores, VAS) was subjectively assessed by patients’ family 2 months later after each treatment. The VAS score ≦ 3 after treatment and a decrease in VAS score of ≧ 5 were considered to indicate a successful result.
RESULTS: A total of 37 treatments were given to the 18 patients. The mean number of treatments given to each patient was 2.055 ± 0.725. After the ending treatment, there was a significant overall improvement in the snoring VAS score (7.611 ± 1.539 to 3.278 ± 2.296). Six patients (33.33%) after the first treatment and thirteen patients (72.22%) after the whole course treatment met the criteria of VAS ≦ 3. Nine patients (50%) had a decrease in VAS score by 5 or more after the whole course of treatment. The successful rate was 83.33%. Two patients developed mild airway compromise within 12 hours which may have been due to soft palate edema. In 37 treatments, post procedural pain was controlled with oral acetaminophen within 24 hours in 11 treatments (29.73%) and after the second 24 hours in 3 treatments (8.11%). One patient developed soft palate perfora-tion after the second treatment. One patient suffered from lump sensation after the second treatment. No pre-existing speech problems were adversely affected.
CONCLUSION: Non-temperature-controlled radiofrequency tissue volume reduction of the soft palate offers an alternative approach for the treatment of snoring. Our results indi-cate that it is associated with subjective improvement in snoring in most patients. It also appears to be safer, better-tolerated, to cause less postoperative pain and lower postopera-tive morbidity, to be more amenable to retreatment, and to have a lower procedural cost compared to laser and temperature-controlled RFTVR.

並列關鍵字

radiofrequency ； snoring