Johnson Jonas T, Vates Jennifer, Wagner Robin L
Department of Otolaryngology, University of Pittsburgh School of Medicine, PA 15213, USA.
Ear Nose Throat J. 2008 Jan;87(1):40-3.
We evaluated the effectiveness of using a plasma-mediated radiofrequency-based ablation (Coblation) device to perform volumetric tissue reduction of the soft palate as a means of controlling snoring in 23 patients with loud snoring and mild or no sleep apnea. Tissue reduction was achieved by performing a channeling procedure designed to shrink the tissue surrounding the treatment zone. The soft palate was treated at three separate sites, and each channel was completed in approximately 11 seconds. Data regarding the primary outcome--that is, pre- and postoperative subjective assessments of snoring intensity provided by the patients' bed partners--were available for comparison for 21 of the 23 patients. Of the 21 patients, treatment was deemed successful in 10 (48%). Postoperatively, the overall mean intensity of snoring on a scale of 0 (no snoring) to 10 (terrible snoring) fell by 4 points (p < 0.05). Likewise, the loudness of snoring was also significantly reduced on objective SNAP recordings; the mean intensity fell from 12 to 8 dB (p < 0.05). Of the 10 successfully treated patients, 2 required only one procedure, 5 were improved after two treatments, and 3 underwent three operations. Seventeen of the 23 patients (74%) reported an improvement in quality of life. Surgical complications were mild to moderate, and pain was easily manageable in most cases. Our findings suggest that this procedure can be an effective treatment for socially unacceptable snoring. We hope that in future studies, investigators will evaluate outcomes over a longer term.
我们评估了使用基于等离子体介导的射频消融(低温消融)设备对软腭进行组织容积减小,以此作为控制23例鼾声响亮且伴有轻度睡眠呼吸暂停或无睡眠呼吸暂停患者打鼾的一种方法。通过实施旨在使治疗区域周围组织收缩的通道化手术来实现组织容积减小。在软腭的三个不同部位进行治疗,每个通道大约11秒完成。23例患者中有21例可获得关于主要结局的数据,即患者同床伴侣提供的术前和术后打鼾强度主观评估,以便进行比较。在这21例患者中,10例(48%)治疗成功。术后,鼾声强度在0(无打鼾)至10(严重打鼾)的量表上总体平均强度下降了4分(p<0.05)。同样,客观的SNAP记录显示打鼾响度也显著降低;平均强度从12 dB降至8 dB(p<0.05)。在10例治疗成功的患者中,2例仅需一次手术,5例在两次治疗后有所改善,3例接受了三次手术。23例患者中有17例(74%)报告生活质量有所改善。手术并发症为轻至中度,大多数情况下疼痛易于控制。我们的研究结果表明,该手术对于社会难以接受的打鼾可能是一种有效的治疗方法。我们希望在未来的研究中,研究人员将对更长时间的结局进行评估。