Bäck Leif J J, Liukko Tommi, Rantanen Irma, Peltola Jaakko S, Partinen Markku, Ylikoski Jukka, Mäkitie Antti A
Department of Otorhinolaryngology, Finland.
Laryngoscope. 2009 Aug;119(8):1621-7. doi: 10.1002/lary.20562.
OBJECTIVES/HYPOTHESIS: Radiofrequency (RF) surgery of the soft palate (SP) is an established treatment option for the treatment of snoring. Due to its minimally invasive character, it has received attention in the management of mild obstructive sleep apnea syndrome (OSAS).
The aim of this study was to assess the efficacy and the occurrence of adverse events after single-stage SP RF surgery in patients with mild OSAS in a randomized single-blinded placebo-controlled trial in an outpatient department at a tertiary care center, academic teaching hospital.
Thirty-two patients with mild OSAS (apnea-hypopnea index [AHI] 5-15, body mass index <35) were randomized to receive a single session of RF surgery or placebo (insertion of applicator without energy delivery) with local anesthesia. The primary outcome measures were (AHI), Epworth Sleepiness Scale, and a 36-item short-form health survey quality-of-life questionnaire. The secondary measures were the soft tissue airway parameters in cephalometric radiographs, snoring scores, and rates of adverse events.
Neither objectively measured significances (active AHI 11.0 [5.0-9.0] to 13.0 [2.0-26.0] and placebo AHI 12.0 [5.0-8.0] to 11.0 [1.0-29.0], P = .628), nor were trends of a diminishing effect on symptoms of mild OSAS found in the treatment arms. No significant changes in the soft tissue airway parameters occurred. One patient (5.9%) in the active treatment group was cured.
RF surgery of SP is not recommended as a single-stage approach in mild OSAS.
目的/假设:软腭射频手术是治疗打鼾的一种既定治疗选择。由于其微创特性,在轻度阻塞性睡眠呼吸暂停综合征(OSAS)的管理中受到关注。
本研究的目的是在一家三级医疗中心、学术教学医院的门诊部进行的一项随机单盲安慰剂对照试验中,评估轻度OSAS患者单阶段软腭射频手术后的疗效和不良事件发生率。
32例轻度OSAS患者(呼吸暂停低通气指数[AHI]为5 - 15,体重指数<35)被随机分配接受单疗程射频手术或安慰剂治疗(插入施药器但不输送能量),采用局部麻醉。主要结局指标为AHI、爱泼华嗜睡量表和一份36项简短健康调查生活质量问卷。次要指标为头颅侧位片中的软组织气道参数、打鼾评分和不良事件发生率。
无论是客观测量的显著性(活性治疗组AHI从11.0[5.0 - 9.0]降至13.0[2.0 - 26.0],安慰剂组AHI从12.0[5.0 - 8.0]降至11.0[1.0 - 29.0],P = 0.628),还是在治疗组中未发现对轻度OSAS症状有逐渐减轻作用的趋势。软组织气道参数未发生显著变化。活性治疗组有1例患者(5.9%)治愈。
不建议将软腭射频手术作为轻度OSAS的单阶段治疗方法。