Submucosal radiosurgical uvulopalatoplasty for the treatment of snoring: Is the monitoring of tissue impedance and temperature necessary?

OBJECTIVE

To determine the safety and efficacy of submucosal radiofrequency uvulopalatoplasty. This procedure uses fixed, predetermined parameters of application without the concomitant monitoring of tissue impedance and temperature in the submucosal radiofrequency induced ablation and volumetric reduction of the soft palate as a treatment of chronic socially disruptive snoring.

DESIGN

This nonrandomized prospective study used preoperative and postoperative questionnaires and visual analogue scales to evaluate snoring and postoperative pain.

SETTING

Treatments were performed on an outpatient basis in a community-based clinic.

PATIENTS

Nineteen patients sought treatment for chronic socially disruptive snoring, without complaints of excessive daytime somnolence, who met the predetermined criteria of a respiratory distress index of less than 20.

INTERVENTION

Radiofrequency energy (3.8 MHZ) was applied to the submucosal tissues of the soft palate through a specially designed needle electrode with a predetermined wattage and treatment time. The number of treatments ranged from 1 to 6 (mean, 3.1). Resolution of snoring or diminution of snoring, to the point where it was no longer bothersome to the patients' bedmate, was considered the successful endpoint of the treatments.

RESULTS

Sixteen patients were successfully treated and satisfied with the results. Three patients had only mild or moderate improvement in snoring despite multiple treatments. Postoperative pain was rated as mild (< or = 3 on the visual analogue scale) in 86% of treatments. In 8 (14%) of 58 treatments, mucosal injury was inadvertently sustained, but all healed without complications.

CONCLUSION

Submucosal radiofrequency uvulopalatoplasty, using the described technique, appears to be a safe, effective, and well-tolerated treatment for chronic socially disruptive snoring. These initial results indicate that the concomitant monitoring of tissue impedance and tissue temperature during radiofrequency ablation and volumetric reduction of the soft palate is not necessary and adds significantly to the cost of the procedure.