Department of Otolaryngology, Faculty of Medicine, |Srinakharinwirot University, Sukhumvit 23, Wattana, Bangkok, 10110, Thailand.
Lasers Med Sci. 2020 Aug;35(6):1231-1238. doi: 10.1007/s10103-020-02987-3. Epub 2020 Feb 28.
A new outpatient non-surgical method using Er:YAG laser for snoring has been demonstrated. The aim of this systematic review and meta-analysis was to investigate the effects of this treatment on snoring. Relevant 1548 articles were searched from various databases from 1 January 2000 to September 2018 including PubMed, MEDLINE, EMBASE, Cochrane Library, Web of Science, and Scopus and reference lists. Meta-analysis was performed with RevMan software. Cochran's Q and I statistics were used to assess heterogeneity. The overall effect was evaluated using z-tests. Seven studies and two hundred forty-seven participants treated with two to three sessions of Er:YAG 2940 nm laser (long pulse mode, 10 Hz, fluence 1.6 J/cm) were included. There was a statistically significant reduction of pooled snoring VAS (mean difference (MD) (95% CI), - 6.89 (- 7.62, - 6.15)). Patient satisfaction rate after laser treatment was 80% (95% CI, 70.69, 89.05) of cases. A widening of the upper airway dimension was revealed; however, changes in apnea-hypopnea index (AHI) and respiratory disturbance index (RDI) were not significantly different. Mean follow-up period was 3 to 36 months. Patients tolerated the procedure well without anesthesia. There were minimal side effects without serious adverse effects. Er:YAG laser is shown to be effective in a way to reduce snoring without significant AHI or RDI changes. However, randomized controlled trials, objective data, multicenter cooperation, and long-term outcomes are needed to confirm the benefits of this laser for snoring.
一种新的门诊非手术方法，使用 Er:YAG 激光治疗打鼾，已经得到了证实。本系统评价和荟萃分析的目的是研究这种治疗方法对打鼾的影响。从 2000 年 1 月 1 日至 2018 年 9 月，从各种数据库（PubMed、MEDLINE、EMBASE、Cochrane 图书馆、Web of Science 和 Scopus）和参考文献中搜索了 1548 篇相关文章。使用 RevMan 软件进行荟萃分析。Cochran's Q 和 I 统计量用于评估异质性。使用 z 检验评估总体效果。共纳入 7 项研究，247 例患者接受 2 至 3 次 2940nm Er:YAG 激光（长脉冲模式，10Hz，能量密度 1.6J/cm）治疗。打鼾 VAS 的汇总结果显示有统计学意义的降低（均数差（MD）（95%置信区间），-6.89（-7.62，-6.15））。激光治疗后患者的满意度为 80%（95%置信区间，70.69，89.05）。上气道尺寸的扩大得到了证实；然而，呼吸暂停低通气指数（AHI）和呼吸紊乱指数（RDI）的变化无显著差异。平均随访时间为 3 至 36 个月。患者无需麻醉即可耐受该治疗。仅有轻微的副作用，没有严重的不良反应。Er:YAG 激光在减少打鼾方面是有效的，而 AHI 或 RDI 无明显变化。然而，需要随机对照试验、客观数据、多中心合作和长期结果来证实这种激光治疗打鼾的益处。
