Blumen Marc Bernard, Dahan Serge, Fleury Bernard, Hausser-Hauw Chantal, Chabolle Frederic
Department of Otolaryngology-Head and Neck Surgery, Foch Hospital, Suresnes, France.
Laryngoscope. 2002 Nov;112(11):2086-92. doi: 10.1097/00005537-200211000-00033.
OBJECTIVES/HYPOTHESIS: Obstructive sleep apnea syndrome is due to pharyngeal obstructions, which can take place at the level of the soft palate. Temperature-controlled radiofrequency ablation has been introduced as being capable of reducing soft tissue volume and excessive compliance. The aim of the study was to evaluate prospectively the possible efficacy of temperature-controlled radiofrequency ablation applied to the soft palate in subjects with mild to moderate obstructive sleep apnea syndrome.
Twenty-nine patients with a respiratory disturbance index between 10 and 30 events per hour, body mass index equal to or less than 30 kg/m2, and obstruction at the level of the soft palate were included in a pilot, prospective nonrandomized study.
Snoring and daytime sleepiness were evaluated subjectively. Treatment (maximum of three sessions) was discontinued when the bed partner was satisfied with the snoring level. A full night recording was performed at least 4 months after the last treatment.
Mean snoring level decreased significantly from 8.6 +/- 1.3 to 3.3 +/- 2.5 on a visual analogue scale (0-10). Daytime sleepiness decreased nonsignificantly. Mean respiratory disturbance index decreased significantly from 19.0 +/- 6.1 events per hour to 9.8 +/- 8.6 events per hour. Mean lowest oxygen saturation value increased nonsignificantly from 85.3% +/- 4.1% to 86.4% +/- 4.4%. Of the patients, 65.5% were cured of their disease.
Temperature-controlled radiofrequency ablation was effective in selected patients with mild to moderate obstructive sleep apnea syndrome. A full-night polysomnography is required after completion of treatment to rule out residual disease.
目的/假设：阻塞性睡眠呼吸暂停综合征是由咽部阻塞引起的，这种阻塞可能发生在软腭水平。温度控制射频消融术已被引入，据称能够减少软组织体积和过度顺应性。本研究的目的是前瞻性评估温度控制射频消融术应用于轻度至中度阻塞性睡眠呼吸暂停综合征患者软腭的可能疗效。
29例呼吸紊乱指数为每小时10至30次事件、体重指数等于或小于30kg/m²且软腭水平存在阻塞的患者被纳入一项前瞻性非随机试点研究。
主观评估打鼾和日间嗜睡情况。当患者的床伴对打鼾水平满意时，停止治疗（最多三个疗程）。在最后一次治疗后至少4个月进行整夜记录。
在视觉模拟量表（0-10）上，平均打鼾水平从8.6±1.3显著降至3.3±2.5。日间嗜睡情况无显著下降。平均呼吸紊乱指数从每小时19.0±6.1次事件显著降至9.8±8.6次事件。平均最低血氧饱和度值从85.3%±4.1%无显著升至86.4%±4.4%。65.5%的患者治愈。
温度控制射频消融术对部分轻度至中度阻塞性睡眠呼吸暂停综合征患者有效。治疗完成后需要进行整夜多导睡眠图检查以排除残留疾病。
