ABSTRACT
OBJECTIVES: The aim of this study was to assess the effectiveness and morbidity of the combined use of bipolar radiofrequency uvulopalatoplasty and a sclerosing agent applied to the soft palate in patients with snoring and apnea during a 1-year follow-up period. METHODS: This was a prospective, nonrandomized study. Twenty-eight patients with primary snoring due to palatal flutter who fulfilled the inclusion criteria were enrolled. Under local anesthesia, a single procedure uvulopalatoplasty using bipolar radiofrequency applied with sterilized forceps was undertaken in combination with a sclerosing agent. RESULTS: Four patients required a repeat procedure 6 weeks after the initial operation. The postoperative Epworth Sleepiness Scale score improved significantly 360 days after surgery. Snoring, measured on the Visual Analogue Scale, decreased from 8.9 +/- 0.7 to 4.1 +/- 1.4 (p < 0.005). No complications were reported. The average reduction on the apnea-hypopnea index was from 24.2 +/- 7.1 to 12.8 +/- 4.4 (p < 0.005). CONCLUSION: Bipolar radiofrequency uvulopalatoplasty combined with injection snoreplasty is an ambulatory, cost-effective, simple, and safe method to reduce the occurrence and effects of snoring and apnea.
Subject(s)
Catheter Ablation/instrumentation , Disorders of Excessive Somnolence/diagnosis , Endoscopy/methods , Palate, Soft/surgery , Sclerosing Solutions/therapeutic use , Snoring/drug therapy , Snoring/surgery , Uvula/surgery , Adult , Aged , Combined Modality Therapy , Disorders of Excessive Somnolence/epidemiology , Equipment Design , Female , Humans , Male , Middle Aged , Postoperative Care , Prospective Studies , Severity of Illness Index , Sleep Apnea, Obstructive/diagnosis , Sleep Apnea, Obstructive/epidemiology , Snoring/diagnosis , Snoring/epidemiology , Surveys and Questionnaires , Treatment Outcome , Young AdultABSTRACT
The aim of this study was to assess the efficacy and morbidity in the use of the palatal implant technique (PITs) in patients with failed uvulopalatopharyngoplasty (UPPP) after a 6-month follow-up period. This was a prospective, nonrandomized study. Sixteen patients who underwent UPPP by the same Institution with Fujita's technique with initial success but developed posterior residual apnea or snoring who fulfilled the inclusion criteria were enrolled. Responses of all patients and their partners were assessed using the visual analogue scale (VAS) and the Epworth sleepiness scale (ESS). Objective data were recorded using ambulatory polysomnography before and at 6 months after surgery. Postoperative VAS and ESS scores significantly improved by 180 days after surgery (P < 0.005). VAS snoring score was reduced from 8.3 +/- 0.8 to 5.5 +/- 1.7 (P < 0.005) and ESS score decreased from 13.3 +/- 5.9 to 10.25 +/- 4.6 (P< 0.005). The apnea-hypopnea index (AHI) decreased from 18.08 +/- 6.02 to 16.8 +/- 5.05 events/h (P = 0.03). The PIT is an effective treatment for snoring and daytime sleepiness of patients with failed UPPPs.
Subject(s)
Palate, Soft/surgery , Pharynx/surgery , Plastic Surgery Procedures/methods , Prosthesis Implantation/methods , Snoring/surgery , Uvula/surgery , Adult , Aged , Female , Follow-Up Studies , Humans , Laryngoscopy , Male , Middle Aged , Polysomnography , Prospective Studies , Reoperation/methods , Snoring/diagnosis , Snoring/physiopathology , Treatment FailureABSTRACT
BACKGROUND: Inferior turbinate hypertrophy is one of the most common causes of nasal airway obstruction in children. Medical treatment often produces very little improvement. Radiofrequency therapy has recently been shown to be safe and effective in volumetric tissue reduction of the turbinates in adults, but no report has been published about its use in children. We prospectively evaluated the safety and effectiveness of radiofrequency volumetric tissue reduction (RVTR) for the treatment of nasal obstruction caused by inferior turbinate hypertrophy in children. METHODS: We followed up 93 children less than 9 years of age who underwent RVTR over 12 months. This surgery was performed with other procedures, such as tonsillectomy with or without grommet insertion (57 patients), tympanoplasty (10 patients), or grommet insertion alone (26 patients). Clinical examination, a medical questionnaire, and scores recorded pre- and postoperatively using Gertner-Podoshin plates were used to assess treatment outcomes 1 month, 6 months and 1 year after surgery. RESULTS: No adverse effects were encountered. One primary bleed due to tonsillectomy was the only complication in this group. Eighty-seven children (94%) had significantly improved nasal breathing postoperatively. CONCLUSIONS: The results of this study demonstrate that RVTR is a safe, effective method for the treatment of turbinate hypertrophy in children. In addition, our data demonstrates good patient acceptance over a period of 1 year.
