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软腭温控射频组织减容术(悬雍垂腭咽成形术)治疗习惯性打鼾:一项欧洲多中心试验的结果

Temperature-controlled radiofrequency tissue volume reduction of the soft palate (somnoplasty) in the treatment of habitual snoring: results of a European multicenter trial.

作者信息

Boudewyns A, Van De Heyning P

机构信息

Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital, Antwerp, Belgium.

出版信息

Acta Otolaryngol. 2000 Oct;120(8):981-5. doi: 10.1080/00016480050218735.

DOI:10.1080/00016480050218735
PMID:11200595
Abstract

Temperature-controlled radiofrequency tissue volume reduction of the soft palate has been introduced as a minimally invasive, outpatient procedure for the treatment of habitual snoring and mild obstructive sleep apnea. A prospective, non-randomized multi-center European clinical study was conducted to investigate the efficacy of Somnoplasty in reducing snoring. Each patient underwent a pre- and post-treatment full-night polysomnography. TCRFe of the soft palate (1 midline lesion/session) was carried out under local anesthesia with a maximum of 3 consecutive treatment sessions. Forty-five, nonapneic snorers (RDI 5.1 +/- 4.3, BMI 26.6 +/- 3.2 kg/m2) completed the protocol. A mean of 692.3 +/- 67.7) J was delivered/treatment session. There was a significant improvement in the snoring index 7.6 (+/- 2.1 ) vs 4.1 (+/- 2.9). p < 0.001 and in the Epworth Sleepiness Score 8.5 (+/- 5.0) versus 6.0 (+/- 4.3), p = 0.001. No major adverse events were reported and postoperative pain was minimal. Overall, 45% of patients had a post-treatment snoring index < 3 (success) and 84% of the patients reported an improvement in snoring. It was concluded that Somnoplasty, following a protocol with I midline lesion of maximal 700 J/lesion for 1-3 treatment sessions, improves snoring in the majority of patients. Further studies are required to investigate whether treatment efficacy can be improved by utilizing multiple lesions/session or by increasing the amount of energy/lesion. The absence of serious adverse events and the findings of minimal postoperative pain support the use of TCRFe (Somnoplasty) as a minimally invasive surgical procedure for snoring.

摘要

软腭温控射频组织减容术已作为一种治疗习惯性打鼾和轻度阻塞性睡眠呼吸暂停的微创门诊手术被引入。一项前瞻性、非随机的多中心欧洲临床研究旨在调查射频组织体积缩小术(Somnoplasty)治疗打鼾的疗效。每位患者在治疗前后均接受整夜多导睡眠监测。在局部麻醉下对软腭进行温控射频组织减容术(每次治疗1个中线病灶),最多连续治疗3次。45名非呼吸暂停性打鼾者(呼吸紊乱指数5.1±4.3,体重指数26.6±3.2kg/m²)完成了该方案。每次治疗平均释放能量692.3±67.7焦耳。打鼾指数有显著改善,从7.6(±2.1)降至4.1(±2.9),p<0.001;Epworth嗜睡评分从8.5(±5.0)降至6.0(±4.3),p = 0.001。未报告重大不良事件,术后疼痛轻微。总体而言,45%的患者治疗后的打鼾指数<3(成功),84%的患者报告打鼾情况有所改善。得出的结论是,按照每次治疗1个中线病灶、最大能量700焦耳/病灶、进行1 - 3次治疗的方案进行射频组织体积缩小术,可使大多数患者的打鼾情况得到改善。需要进一步研究以探讨通过每次使用多个病灶或增加每个病灶的能量是否能提高治疗效果。未出现严重不良事件以及术后疼痛轻微这一结果支持将温控射频组织减容术(射频组织体积缩小术)作为一种治疗打鼾的微创手术方法。

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