Gerek Mustafa, Akçam Timur, Durmaz Abdullah
Department of Otolaryngology, Gülhane Military Medical School, Ankara, Turkey.
Kulak Burun Bogaz Ihtis Derg. 2005;14(3-4):67-78.
We examined the early effects of radiofrequency thermal ablation performed to the soft palate on snoring level, apnea index (AI), and daytime sleepiness of patients with simple snoring or mild obstructive sleep apnea (OSA).
The study included 88 patients having a diagnosis of simple snoring without apnea (n=61), apnea with AI < or = 5 (n=13), and mild OSA with 5 < or = AI < or = 15 (n=14). Radiosurgery was performed to three or four locations on the soft palate and uvula under local anesthesia, with some patients requiring a subsequent procedure. The results were evaluated two months after the final session using the Epworth Sleepiness Scale (ESS) and visual analog scale (VAS).
The complaints completely disappeared in three patients (3.4%). Improvement was more than 50% in 79 patients (89.7%) and less than 50% in two patients (2.2%). There was no change in four patients. The mean snoring symptom level, snoring noise level, ESS score, and apnea index were 3.01+/-1.96, 1.43+/-0.79, 3.55+/-2.58, and 3.20+/-1.85, respectively. The results were significantly improved compared to pretreatment values in all the patient groups (p<0.001).
Radiofrequency thermal ablation is an effective and well tolerable treatment method for simple snoring, mild OSA, and associated daytime sleepiness, with minimal postoperative morbidity and a low complication rate.
我们研究了对软腭进行射频热消融术对单纯打鼾或轻度阻塞性睡眠呼吸暂停(OSA)患者打鼾程度、呼吸暂停指数(AI)及日间嗜睡情况的早期影响。
本研究纳入了88例患者,其中诊断为无呼吸暂停的单纯打鼾患者(n = 61)、AI≤5的呼吸暂停患者(n = 13)以及5<AI≤15的轻度OSA患者(n = 14)。在局部麻醉下,对软腭和悬雍垂的三到四个部位进行放射外科手术,部分患者需要后续治疗。在最后一次治疗两个月后,使用爱泼华嗜睡量表(ESS)和视觉模拟量表(VAS)对结果进行评估。
3例患者(3.4%)的症状完全消失。79例患者(89.7%)改善超过50%,2例患者(2.2%)改善不足50%。4例患者无变化。打鼾症状水平、打鼾噪音水平、ESS评分及呼吸暂停指数的平均值分别为3.01±1.96、1.43±0.79、3.55±2.58和3.20±1.85。与所有患者组的治疗前值相比,结果均有显著改善(p < 0.001)。
射频热消融术是治疗单纯打鼾、轻度OSA及相关日间嗜睡的一种有效且耐受性良好的治疗方法,术后发病率极低且并发症发生率低。