COMPARATIVE EFFECTIVENESS OF RADIOFREQUENCY UVULOPLASTY VERSUS

RADIOFREQUENCY REDUCTION OF SOFT PALATE IN TREATING SNORING AND

MILD AND MODERATE OBSTRUCTIVE SLEEP APNEA SYNDROME

G.L.Khandanyan, G.I. Petrosyants, I.K. Morsikyan, A.K. Shukuryan

Radiofrequency surgery of the so� palate presents a promising alternative for the treatment of sleep-disor-dered breathing (SDB). A clinical trial using either ra-diofrequency (RF) uvuloplasty or simultaneous RF of the so� palate and the inferior nasal turbinates was inves-tigated to determine comparative effi cacy of these two methods in the treatment of snoring and mild to moder-ate Obstructive Sleep Apnea Syndrome (OSAS).

A prospective study of 56 snorers and/or OSAS patients were investigated concerning before and, at minimum, 2 months a� er the RF surgery against SDB. Among them, 24 patients underwent RF reduction of the inferior nasal turbinates and RF reduction of so� palate (Group 1), and the remaining 32 underwent RF reduction of the inferior nasal turbinates, medial regions of the so� palate as well as RF uvuloplasty. We made between-group comparison of post-surgical changes of practice param-eters: Body Mass Index (BMI), nasal breathing (airfl ow), snoring, apnea hypopnea index (AHI), daytime sleepiness measured by Epworth Sleepiness Scale (ESS) and severi-

ty of post-surgery pain (VAS).

We observed no post-surgery signifi cant changes of patients’ BMI in either of group. Post-surgery nasal turbinate airfl ow was completely restored in 79% of pa-tients in Group 1 vs. 84.5% of those in Group 2. A� er surgery, nasal mild breathing impairment was found in 12.5% of patients both in Group 1 and 2. In addition, a� er nasal surgery, loudness of snoring dropped from 8.1±1.3 to 5.2±2.4 in Group 1 and from 8.4±2.2 to 2.7±2.3 in Group 2 (P<0.05 for both). AHI decreased from 18.2±4.2 to 10.4±3.7 in Group 1 and from 19.4±5.5 to 5.9±1.73 in Group 2 (P<0.05 for both). ESS also de-creased from 9.5±3.5 to 5.2±2.2 in Group 1 and from 9.3±3.6 to 2.3±1.81 in Group 2 (P<0.05 for both). How-ever, post-surgery pain index was greater in Group 2 than in Group 1 (7.2±2.6 vs. 3.8±3.2, P<0.05).

Both nasal surgery approaches are acceptable for the treatment of snoring. Though the 2nd approach seems a bit more eff ective, it may cause more intensive post-sur-gery pain.

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