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RADIOFREQUENCY TREATMENT FOR SNORING PROVES TO BE EQUALLY EFFECTIVE AS SURGICAL PROCEDURES LAUP AND UPPP

A California study contends that when snoring relapses, patients who initially received Somnoplasty are more willing to undergo additional treatments.

New Orleans -- Two years ago, radiofrequency volumetric reduction of the palate was introduced to the snoring world as Somnoplasty . The effects of this new technology were immediate: medical investigators found a 77 percent reduction in snoring; mmore important, the study determined that radiofrequency in the soft palate was safe, relatively pain-free, and neither speech nor swallowing was adversely affected.

When introduced, this relatively painless and unobtrusive procedure to alleviate snoring generated significant media coverage. Despite encouraging initial results, the long-term outcome of treatment as well as the effects of the new technology on the delicate soft palate was unknown. A team of otolaryngologists set about to evaluate the effect of radiofrequency volumetric reduction of the palate on speech, swallowing, taste, sleep, and snoring 12 to 18 months following treatment. The secondary objectives of the study were to evaluate the effect of additional radiofrequency treatments to the soft palate of patients with relapse of snoring.

The authors of the research study, "Radiofrequency Volumetric Reduction of the Palate: An Extended Follow-Up Study" are Kasey Li, MD, DDS, Nelson Powell, MD, Robert W. Riley, MD, DDS, Robert Troell, MD, and Christian Guilleminault, MD, all from the Stanford Sleep Disorders and Research Center, Stanford, CA.

The results were presented before the American Academy of Otolaryngology--Head and Neck Surgery Foundation Annual Meeting and Oto Expo being held September 26-29 at the Ernest N. Morial Convention Center in New Orleans, LA. At the gathering, the Academy's 13,000 members will have the opportunity to hear the latest research in the diagnosis and treatment of disorders of the ear, nose, throat, and related structures of the head and neck.

Methodology.

This research prospectively followed the first 22 patients (18 men) with sleep-disordered breathing treated with radiofrequency of the palate 12 to 18 months prior. Clinical examination was performed on all patients, and questionnaires and visual analog scales were used to subjectively assess speech, swallowing, taste, sleep, and snoring. Patients who had incurred a relapse of snoring were offered additional radiofrequency treatments. After additional treatments, the research variables were re-assessed in those patients.

Twenty-two patients were enrolled in the study. All had sought treatment for chronic, habitual snoring and reported symptoms of daytime sleepiness prior to the study. The mean age of the subjects was 45.3 + 9.1 years; diagnosis of obstructive sleep apnea was found in seven (31.8 percent) patients and upper airway syndrome (UARS) in 14 patients (63.6 percent). The diagnosis of the remaining patients was either simple snoring or UARS.

Results:

All 22 patients underwent follow-up for an average evaluation period of 14 months. The key findings of the study were:

* None of the patients reported an adverse effect on speech, swallowing, or taste.

* Thirteen patients (59 percent) reported no relapse of snoring. Nine patients (41 percent) reported relapse of snoring. The palate length, palate width, posterior airway space, and the total amount of radiofrequency energy delivered during treatment did not affect the relapse rate.

* Twenty-one (95 percent) of the patients were satisfied with the procedure and stated they would undergo treatment again. One patient felt that there was insufficient response to the treatment and would not have the procedure again.

* Eight of the nine patients who relapsed received additional treatments to further control snoring , and they underwent a total of ten radiofrequency treatments. Six patients received one procedure, and two patients received two treatments.

Conclusion. The results of the study suggest that the success of radiofrequency volumetric reduction of the palate diminishes with time. The 12 to 18 month variables are, at a minimum, comparable to other forms of surgical palatal modification such as laser assisted uvulopalatoplasty (LAUP) and uvulopalatopharyngoplasty (UPPP). However, the minimal invasiveness of radiofrequency provided high patient acceptance of re-treatment, thereby addressing snoring relapse.

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Editor's Note: For a copy of this study or an interview with Dr. Li, contact Ken Satterfield at 703-519-1563 (through 9-21); 9/23-29, call the Annual Meeting Â鶹´«Ã½room at 504-670-5409.