Belloso A, Morar P, Tahery J, Saravanan K, Nigam A, Timms M S
Department of Otolaryngology, Blackpool Victoria Hospital, UK.
Clin Otolaryngol. 2006 Apr;31(2):138-43. doi: 10.1111/j.1749-4486.2006.01174.x.
This study aimed to evaluate differences in post-operative pain comparing KTP laser-assisted uvulopalatoplasty without tonsillectomy (LAUP) with a new described surgical method: coblation uvulopalatoplasty with tonsillectomy (CP). We also evaluate the impact of each surgical technique in reduction of snoring loudness.
Single blind randomized-controlled trial. From a population of 41 consecutive patients on the waiting list for uvulopalatoplasty for simple snoring, the study group was reduced to 17 CP and 13 LAUP. Post-operative pain and reduction of snoring loudness were recorded using visual analogue scales (VAS) during the first 15 post-operative days. Post-operative snoring loudness was documented for 1-year period.
Both groups had similar post-operative pain during the first seven post-operative days. A statistically significant reduction in post-operative pain was observed in the CP group after day 8, and maintained until the end of the study. Reduction of snoring loudness was significant in both groups, but no differences were observed between them.
Coblation uvulopalatoplasty compared with LAUP demonstrates a reduction in post-operative pain, significant after the first post-operative week. The collateral thermal injury caused by laser is responsible for the slow-healing rate and maintained post-operative pain. Coblation dissociates tissue at lower temperatures with minimal collateral thermal injury and consequently faster and less painful recovery. Both surgical procedures have significant and similar reduction in snoring loudness.
Both methods are adequate treatment options for snoring. The less painful recovery in CP promotes this surgical technique as our preferred choice for palate surgery.
本研究旨在评估不进行扁桃体切除术的KTP激光辅助悬雍垂腭咽成形术（LAUP）与一种新描述的手术方法：联合使用扁桃体切除术的等离子悬雍垂腭咽成形术（CP）在术后疼痛方面的差异。我们还评估了每种手术技术对降低打鼾响度的影响。
单盲随机对照试验。从41名连续列入单纯打鼾悬雍垂腭咽成形术等待名单的患者群体中，研究组缩减为17名接受CP手术的患者和13名接受LAUP手术的患者。在术后的前15天内，使用视觉模拟量表（VAS）记录术后疼痛和打鼾响度的降低情况。记录术后1年的打鼾响度。
两组在术后的前7天内术后疼痛情况相似。在术后第8天之后，CP组的术后疼痛出现了统计学上的显著降低，并一直维持到研究结束。两组的打鼾响度均有显著降低，但两组之间未观察到差异。
与LAUP相比，等离子悬雍垂腭咽成形术在术后疼痛方面有所降低，在术后第一周后较为显著。激光造成的侧方热损伤导致愈合速度缓慢和术后疼痛持续。等离子技术在较低温度下分离组织，侧方热损伤最小，因此恢复更快且疼痛更小。两种手术方法在降低打鼾响度方面均有显著且相似的效果。
两种方法都是治疗打鼾的合适选择。CP手术恢复时疼痛较小，这促使我们将这种手术技术作为腭部手术的首选。
