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射频消融治疗打鼾患者软腭:有效性和不良反应的系统评价

Radiofrequency ablation treatment of soft palate for patients with snoring: a systematic review of effectiveness and adverse effects.

作者信息

Bäck Leif J J, Hytönen Maija L, Roine Risto P, Malmivaara Antti O V

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, Helsinki University Central Hospital, Helsinki, Finland.

出版信息

Laryngoscope. 2009 Jun;119(6):1241-50. doi: 10.1002/lary.20215.

Abstract

OBJECTIVE

To assess the effectiveness and adverse effects of radiofrequency ablation (RFA) of soft palate (SP) in snoring.

STUDY DESIGN

Systematic search of electronic databases. Only articles published in peer-reviewed journals were evaluated. Included were controlled or prospective studies with at least 10 adults (> or =18 years of age) without moderate/severe obstructive sleep apnea.

RESULTS

Of the 159 articles identified, 30 met the inclusion criteria: two randomized controlled trials (RCT), four clinical controlled trials, and 24 prospective uncontrolled studies. The only placebo controlled RCT indicated SP RFA to be superior compared to placebo. The other RCT, comparing different radiofrequency ablation generators, showed no evidence of differences in snoring treatment efficacy, and only minor differences in patient discomfort. In two of the controlled trials snoring relief obtained by SP RFA was comparable, and in three of them associated with less postoperative pain than other interventions. Radiologic results were contradictory with some trials reporting significant changes of the upper airways, whereas others did not. Neither long-term side effects nor major adverse events have been reported after.

CONCLUSIONS

The review provides evidence that SP RFA is an intervention causing less postoperative pain than others, and the risk of adverse effects for the patient seems to be small. It may reduce symptoms of snoring, at least in the short term. However, most of the published SP RFA literature is based on observational studies with a short follow-up time, which precludes solid conclusions about the effectiveness of the procedure. Laryngoscope, 2009.

摘要

目的

评估软腭射频消融术(RFA)治疗打鼾的有效性和不良反应。

研究设计

系统检索电子数据库。仅评估发表在同行评审期刊上的文章。纳入的研究为至少有10名成年人(≥18岁)且无中度/重度阻塞性睡眠呼吸暂停的对照研究或前瞻性研究。

结果

在检索到的159篇文章中,30篇符合纳入标准:两项随机对照试验(RCT)、四项临床对照试验和24项前瞻性非对照研究。唯一的安慰剂对照RCT表明软腭RFA优于安慰剂。另一项比较不同射频消融发生器的RCT显示,在打鼾治疗效果上没有差异,仅在患者不适方面存在微小差异。在两项对照试验中,软腭RFA缓解打鼾的效果相当,在三项试验中,与其他干预措施相比,术后疼痛较轻。影像学结果相互矛盾,一些试验报告上气道有显著变化,而另一些则没有。此后未报告长期副作用或重大不良事件。

结论

该综述提供的证据表明,软腭RFA是一种术后疼痛比其他方法轻的干预措施,对患者的不良反应风险似乎较小。它可能至少在短期内减轻打鼾症状。然而,大多数已发表的软腭RFA文献基于随访时间较短的观察性研究,这使得无法就该手术的有效性得出确凿结论。《喉镜》,2009年。

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