Rombaux Philippe, Hamoir Marc, Bertrand Bernard, Aubert Genevieve, Liistro Giuseppe, Rodenstein Daniel
Department of Otorhinolaryngology, Université Catholique de Louvain, Cliniques Universitaires Saint Luc, Hippocrate Avenue 10, 1200 Brussels, Belgium.
Laryngoscope. 2003 Dec;113(12):2169-73. doi: 10.1097/00005537-200312000-00023.
We compared, in a prospective study, the side effects and the postoperative complications of three procedures commonly used for the treatment of primary snoring.
Forty-nine patients underwent velopharyngeal surgery for primary snoring (17 for uvulopalatopharyngoplasty [UPPP]; 15 for laser-assisted uvulopalatoplasty [LAUP], and 17 for radiofrequency tissue volume reduction [RFTVR]). Preoperative full polysomnographic studies ruled out obstructive sleep apnea syndrome. Each patient's evaluation encompassed postoperative pharyngeal pain (as measured by a 5-point visual analogue scale) and use of narcotic drugs in the early postoperative period as well as a subjective evaluation of late postoperative complaints. A surgeon's examination was performed to report postoperative complications in the oropharynx.
Postoperative pharyngeal pain was less important in the RFTVR group than in the UPPP and LAUP groups. Mean scores at days 3, 7, 16 were as follows: 4.2, 4.0, and 2.4, respectively, for UPPP; 4.6, 3.8, and 1.6 for LAUP; and 2.4, 2.0, and 0.7 for RFTVR. Mean duration of pain with a score greater than 2 was calculated as follows: UPPP, 21.3 days; LAUP, 15.1 days; and RFTVR, 6.1 days. Mean duration of narcotic drug use for the patients who needed this medication was 10.1 days for UPPP, 7.2 days for LAUP, and 1.3 for RFTVR. Postoperative side effects (trouble with smell and taste, pharyngeal dryness, globus sensation, voice change, and pharyngonasal reflux) were more present in the UPPP and LAUP groups than in the RFTVR group. Surgeon's assessment for postoperative complications reported more wound infection, dehiscence, and posterior pillar narrowing in the UPPP and LAUP groups than in the RFTVR group.
RFTVR is a safer and less painful procedure than UPPP and LAUP for the treatment of primary snoring. Postoperative discomfort after LAUP and after UPPP appears to be very similar.
在一项前瞻性研究中，我们比较了常用于治疗原发性打鼾的三种手术的副作用和术后并发症。
49例患者因原发性打鼾接受了腭咽手术（17例行悬雍垂腭咽成形术[UPPP]；15例行激光辅助悬雍垂腭成形术[LAUP]；17例行射频组织容积减容术[RFTVR]）。术前全面的多导睡眠图研究排除了阻塞性睡眠呼吸暂停综合征。对每位患者的评估包括术后咽部疼痛（采用5分视觉模拟量表测量）、术后早期使用麻醉药物情况以及对术后晚期不适的主观评估。由外科医生进行检查以报告口咽的术后并发症。
RFTVR组术后咽部疼痛比UPPP组和LAUP组轻。术后第3天、第7天和第16天的平均评分如下：UPPP组分别为4.2、4.0和2.4；LAUP组分别为4.6、3.8和1.6；RFTVR组分别为2.4、2.0和0.7。疼痛评分大于2分的平均持续时间计算如下：UPPP组为21.3天；LAUP组为15.1天；RFTVR组为6.1天。需要使用麻醉药物的患者，UPPP组麻醉药物的平均使用时间为10.1天，LAUP组为7.2天，RFTVR组为1.3天。术后副作用（嗅觉和味觉问题、咽部干燥、球状物感、声音改变和咽鼻反流）在UPPP组和LAUP组比RFTVR组更常见。外科医生对术后并发症的评估报告显示，UPPP组和LAUP组的伤口感染、裂开和后柱狭窄比RFTVR组更多。
对于原发性打鼾的治疗，RFTVR比UPPP和LAUP更安全、痛苦更小。LAUP和UPPP术后的不适似乎非常相似。
