Cammaroto Giovanni, Caccamo Giuseppe, Rodella Tommaso, Angeletti Diletta, Boscolo Nata Francesca, Topazio Davide, Cerritelli Luca
ENT Unit, Morgagni Pierantoni Hospital, 47121 Forli, Italy.
Young Otolaryngologists of the Italian Society of Otolaryngology (GOS-SIO), Italy.
J Clin Med. 2025 Jul 14;14(14):4964. doi: 10.3390/jcm14144964.
: Snoring is a common symptom within the spectrum of sleep-disordered breathing, often occurring independently or in association with obstructive sleep apnea syndrome (OSAS). Despite its prevalence, treatment strategies remain variable and lack standardization, particularly regarding surgical interventions. This review aims to evaluate and summarize the outcomes of soft palate and pharyngeal surgeries for adult snoring based on recent literature. : A systematic review was conducted using the PubMed database, identifying studies published between 2014 and 2024 that involved adult patients undergoing upper airway surgery for snoring. Inclusion criteria required pre- and postoperative snoring assessment using the Visual Analog Scale (VAS). Studies were categorized by surgical technique (anterior vs. lateral/circumferential), anesthesia type, presence of tonsillectomy, BMI, OSAS severity (based on AHI), and use of Drug-Induced Sleep Endoscopy (DISE). Descriptive analysis was performed on the changes in VAS scores. : A total of 43 studies involving 2713 patients were included, with 18 eligible for quantitative analysis (716 patients). Across all patients, mean VAS scores improved from 7.29 to 3.50 (ΔVAS 3.79). Both anterior and lateral/circumferential techniques yielded significant symptom reduction (ΔVAS 4.12 and 3.68, respectively). General anesthesia showed slightly better outcomes than local anesthesia. Notably, tonsillectomy was associated with greater symptom improvement (ΔVAS 5.17 vs. 4.49). Patients with lower BMI and milder OSAS showed higher baseline VAS but similar improvements. Limited objective measures and heterogeneity in surgical protocols were key limitations. : Surgical interventions for snoring provide subjective symptom relief regardless of surgical approach or OSAS severity. Tonsillectomy may enhance outcomes. Future efforts should prioritize standardized, objective outcome measures and personalized treatment planning, potentially incorporating DISE and wearable acoustic technologies.
打鼾是睡眠呼吸障碍范围内的常见症状，通常独立出现或与阻塞性睡眠呼吸暂停综合征（OSAS）相关。尽管其患病率很高，但治疗策略仍然多变且缺乏标准化，尤其是在手术干预方面。本综述旨在根据近期文献评估和总结成人打鼾的软腭和咽部手术的结果。
使用PubMed数据库进行了一项系统综述，确定了2014年至2024年期间发表的涉及接受上气道手术治疗打鼾的成年患者的研究。纳入标准要求使用视觉模拟量表（VAS）进行术前和术后打鼾评估。研究按手术技术（前部与外侧/环形）、麻醉类型、扁桃体切除术的存在、BMI、OSAS严重程度（基于AHI）以及药物诱导睡眠内镜检查（DISE）的使用进行分类。对VAS评分的变化进行了描述性分析。
共纳入43项研究，涉及2713例患者，其中18项符合定量分析标准（716例患者）。在所有患者中，平均VAS评分从7.29提高到3.50（VAS变化值为3.79）。前部和外侧/环形技术均显著减轻了症状（VAS变化值分别为4.12和3.68）。全身麻醉的效果略优于局部麻醉。值得注意的是，扁桃体切除术与更大的症状改善相关（VAS变化值为5.17对4.49）。BMI较低和OSAS较轻的患者基线VAS较高，但改善程度相似。客观测量方法有限和手术方案的异质性是关键限制因素。
无论手术方式或OSAS严重程度如何，打鼾的手术干预都能提供主观症状缓解。扁桃体切除术可能会改善治疗效果。未来的努力应优先考虑标准化的客观结果测量和个性化治疗计划，可能会纳入DISE和可穿戴声学技术。
