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联合射频辅助悬雍垂腭咽成形术治疗打鼾

Combined radiofrequency assisted uvulopalatoplasty in the treatment of snoring.

作者信息

Baisch Alexander, Maurer Joachim T, Hörmann Karl, Stuck Boris A

机构信息

Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Mannheim, 68135, Mannheim, Germany.

出版信息

Eur Arch Otorhinolaryngol. 2009 Jan;266(1):125-30. doi: 10.1007/s00405-008-0709-6. Epub 2008 May 16.

Abstract

Despite its minimally invasive character and superiority over placebo, the clinical efficacy of interstitial radiofrequency surgery (RF) of the soft palate in primary snoring is limited. In particular, excessive soft tissue at the palatal arches (webbing) and uvula hyperplasia are common phenomena, but cannot be addressed with interstitial RF surgery. Aim of this study was to assess the efficacy and morbidity of combined RF assisted uvulopalatoplasty (RF-UPP) in the treatment of snoring. Twenty-two patients with primary snoring (AHI < 15, BMI < 32) were included in the prospective clinical trial. All patients received two sessions of combined RF procedures at the soft palate, consisting of interstitial bipolar RF-surgery (Celon) and RF-assisted resection of excessive soft tissue (Celon ProCut). Snoring and postoperative pain were assessed with a 10-cm visual analogues scale (VAS), before and at least 6 weeks after every treatment session. Twenty-two patients were included and 21 patients completed the study. Snoring scores were reduced after the first session (8.5 +/- 1.5-4.6 +/- 2.5; P < 0.001) and showed further improvement after the second session (4.6 +/- 2.5-2.0 +/- 2.1; P < 0.001). Postoperative pain levels of 6.6 +/- 2.9 at day 1 decreased to 3.2 +/- 3.0 at day 7 after the first session and from 3.8 +/- 3.2 at day 1 to 0.4 +/- 0.8 at day 7 after the second session. Painkillers were administered for a mean of 2.0 +/- 2.5 days. Complications did not occur. Combined radiofrequency assisted uvulopalatoplasty (RF-UPP) is highly effective in the treatment of snoring.

摘要

尽管间质射频手术(RF)具有微创性且优于安慰剂,但软腭间质射频手术治疗原发性打鼾的临床疗效有限。特别是,腭弓处软组织过多(蹼状)和悬雍垂增生是常见现象,但间质射频手术无法解决这些问题。本研究的目的是评估联合射频辅助悬雍垂腭咽成形术(RF-UPP)治疗打鼾的疗效和发病率。22例原发性打鼾患者(呼吸暂停低通气指数<15,体重指数<32)纳入前瞻性临床试验。所有患者均在软腭接受了两期联合射频手术,包括间质双极射频手术(Celon)和射频辅助切除过多软组织(Celon ProCut)。在每次治疗前和至少6周后,使用10厘米视觉模拟量表(VAS)评估打鼾情况和术后疼痛。纳入22例患者,21例患者完成研究。第一期治疗后打鼾评分降低(8.5±1.5-4.6±2.5;P<0.001),第二期治疗后进一步改善(4.6±2.5-2.0±2.1;P<0.001)。第一期治疗后第1天术后疼痛水平为6.6±2.9,第7天降至3.2±3.0;第二期治疗后第1天为3.8±3.2,第7天降至0.4±0.8。平均服用止痛药2.0±2.5天。未发生并发症。联合射频辅助悬雍垂腭咽成形术(RF-UPP)治疗打鼾非常有效。

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