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多级射频消融术对老年睡眠呼吸暂停患者的叠加效应

Additive Effect of Multilevel Radiofrequency Ablation in Elderly Patients with Sleep Apnea.

作者信息

Erfanian Reza, Khorsandi Mitra, Heidari Reihaneh, Jafari Akbar

机构信息

Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Tehran 1145765111 Iran.

Iranian Sleep Medicine Society, Tehran, Iran.

出版信息

Indian J Otolaryngol Head Neck Surg. 2025 Jan;77(1):41-48. doi: 10.1007/s12070-024-05095-8. Epub 2024 Oct 28.

Abstract

Elderly patients with Obstructive sleep apnea (OSA) often struggle with positive airway therapy due to low adherence. This study explores Radiofrequency ablation (RFA) as a treatment alongside weight loss and tongue-retaining device for OSA in older adults. Through a randomized trial, we compare RFA effectiveness to a control group, aiming to establish its potential role in managing OSA in this vulnerable population. The control group received only weight loss and tongue-retaining device recommendations. In the intervention group, these measures were supplemented with RFA of the soft palate and inferior turbinates. After three months, both groups were assessed for changes in sleep study parameters, BMI, and tongue-retaining device adherence. Twenty patients in the control group and 23 in the intervention group completed the trial. The average age was 60.25 years old (SD = 5.88) in the control group and 61.83 years old (SD = 5.21) in the RFA group. Both groups experienced significant BMI reductions, with the control group averaging a decrease of 1.5 kg/m² (SD = 2.4 kg/m²) and the RFA group averaging a decrease of 1.3 kg/m² (SD = 1.1 kg/m²). Tongue-retaining device adherence was 50% in the control group and 56.5% in the RFA group. The RFA group achieved a significantly greater proportionate reduction in AHI compared to the control group ( = 0.04, effect size=-0.38). This randomized controlled trial showed that RFA on the soft palate and inferior turbinate is a well-tolerated and potentially effective treatment option for elderly patients with OSA. Further research with larger samples and longer follow-ups is needed to confirm these findings and assess long-term durability.

摘要

患有阻塞性睡眠呼吸暂停(OSA)的老年患者由于依从性低,在接受气道正压治疗时往往面临困难。本研究探讨了射频消融(RFA)作为一种治疗方法,与减肥和舌保持器一起用于老年OSA患者的治疗。通过一项随机试验,我们将RFA的疗效与对照组进行比较,旨在确定其在管理这一脆弱人群的OSA方面的潜在作用。对照组仅接受减肥和使用舌保持器的建议。在干预组中,这些措施辅以软腭和下鼻甲的射频消融。三个月后,对两组患者的睡眠研究参数、体重指数(BMI)和舌保持器依从性的变化进行评估。对照组有20名患者、干预组有23名患者完成了试验。对照组的平均年龄为60.25岁(标准差=5.88),射频消融组为61.83岁(标准差=5.21)。两组的BMI均显著降低,对照组平均降低1.5kg/m²(标准差=2.4kg/m²),射频消融组平均降低1.3kg/m²(标准差=1.1kg/m²)。对照组舌保持器的依从率为50%,射频消融组为56.5%。与对照组相比,射频消融组的呼吸暂停低通气指数(AHI)按比例降低的幅度显著更大(P=0.04,效应量=-0.38)。这项随机对照试验表明,软腭和下鼻甲的射频消融对于老年OSA患者是一种耐受性良好且可能有效的治疗选择。需要进行更大样本量和更长随访时间的进一步研究来证实这些发现并评估长期疗效。

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