Hussain Salman, Hayat Jafar, Chowdhury Raisa, Ebrahim Mahmoud, Alterki Abdulmohsen, Bahgat Ahmed, Al-Sayed Ahmed A, Padhye Vikram, Capasso Robson
Department of Otolaryngology-Head and Neck Surgery University of Ottawa Ottawa Ontario Canada.
Department of Otolaryngology-Head and Neck Surgery Jaber Al-Ahmad Hospital Kuwait Kuwait.
OTO Open. 2025 Jan 19;9(1):e70076. doi: 10.1002/oto2.70076. eCollection 2025 Jan-Mar.
The objective of this study is to determine the effectiveness and safety profile of coblation tongue base reduction (CBTR) compared to radiofrequency base of tongue (RFBOT) reduction on sleep-related outcomes in patients with obstructive sleep apnea (OSA).
PubMed, Scopus, Web of Science, and Cochrane Database of Systematic Reviews databases.
Literature search by 2 independent authors was conducted using the abovementioned databases. Studies on CBTR and RFBOT as part of OSA treatment in adult patients with pre- and postoperative apnea-hypopnea index (AHI) were included. Direct meta-analysis and single-arm meta-analysis were conducted to compare sleep-related outcomes (AHI, apnea index [AI], surgical success rates, Epworth sleepiness score [ESS], SpO, body mass index [BMI], and visual analog scale [VAS]) between both groups.
A total of 40 studies with a total of 1940 patients were included, of which 1440 individuals who underwent tongue base reduction interventions (RF = 306, RF + UPPP = 656, and coblation + UPPP = 482) met inclusion criteria. Pooled analysis showed significant improvements in AHI (CBTR = -22.84, RFBOT = -11.14), AI (CBTR = 15.64, RFBOT = -5.26), ESS (CBTR = -7.59, RFBOT = -7.18), mean oxygen saturation (CBTR = 7.43, RFBOT = 4.25), mean BMI (CBTR = -0.69, RFBOT = -4.09), and snoring visual analog scale (CBTR = -16.20, RFBOT = -18.21). Surgical success rate (postoperative AHI < 20 and drop >50% from baselines) was 70% for CBTR and 43% for RFBOT.
Both interventions decreased sleep-related outcomes in adult patients with OSA. Coblation appears to exhibit superiority over radiofrequency with a similar safety profile. However, further studies with direct comparisons between both interventions must be performed.
本研究的目的是确定与射频舌根减容术（RFBOT）相比，低温等离子舌根减容术（CBTR）对阻塞性睡眠呼吸暂停（OSA）患者睡眠相关结局的有效性和安全性。
PubMed、Scopus、科学引文索引数据库和Cochrane系统评价数据库。
由2名独立作者使用上述数据库进行文献检索。纳入了将CBTR和RFBOT作为成年OSA患者治疗一部分且有术前和术后呼吸暂停低通气指数（AHI）的研究。进行直接荟萃分析和单臂荟萃分析以比较两组之间的睡眠相关结局（AHI、呼吸暂停指数[AI]、手术成功率、爱泼华嗜睡量表[ESS]、血氧饱和度（SpO）、体重指数[BMI]和视觉模拟评分[VAS]）。
共纳入40项研究，总计1940例患者，其中1440例接受舌根减容干预的个体（射频消融术[RF]=306例，射频消融术联合悬雍垂腭咽成形术[RF+UPPP]=656例，低温等离子联合悬雍垂腭咽成形术[coblation+UPPP]=482例）符合纳入标准。汇总分析显示，AHI（CBTR=-22.84，RFBOT=-11.14）、AI（CBTR=15.64，RFBOT=-5.26）、ESS（CBTR=-7.59，RFBOT=-7.18）、平均血氧饱和度（CBTR=7.43，RFBOT=4.25）、平均BMI（CBTR=-0.69，RFBOT=-4.09）和打鼾视觉模拟评分（CBTR=-16.20，RFBOT=-18.21）均有显著改善。CBTR的手术成功率（术后AHI<20且较基线下降>50%）为70%，RFBOT为43%。
两种干预措施均能改善成年OSA患者的睡眠相关结局。低温等离子在安全性相似的情况下似乎比射频消融术更具优势。然而，必须进行两种干预措施之间直接比较的进一步研究。
