Document Detail


Plasma radiofrequency preceded by pressure recording enhances success for treating sleep-related breathing disorders.
MedLine Citation:
PMID:  17415146     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Sleep-related breathing disorders (SRBD) that cannot be treated conservatively are commonly treated using uvulopalatopharyngoplasty, although success rates are generally less than 70%. The purpose of this study was to assess a plasma-mediated radiofrequency (RF)-based coblation assisted upper airway procedure (CAUP) to treat SRBD patients determined to have obstruction localized to the upper (mid)-pharyngeal region. STUDY DESIGN: Prospective case series (n = 40). METHODS: Six patients had socially bothersome snoring, and 34 patients had mild to moderate sleep apnea (apnea/hypopnea index [AHI] <20), with the primary level of obstruction (>50%) within the upper pharyngeal region as determined using whole night recordings, including airway pressure fluctuation monitoring (ApneaGraph, MRA-Medical Ltd, Gloucestershire, UK). CAUP consisted of making a lateral palatal incision, ablating three upward channels on each side of the midline (fan-shaped) into the soft palate using a plasma mediated RF-based device (ArthroCare Corporation, Austin, TX), and performing a partial uvulectomy. Clinical outcomes included the Epworth Sleepiness Scale (ESS), partner rating of snoring using a visual analogue scale (VAS), and night-time apnea and hypopnea events (AHI, hypopnea index [HI], apnea index [AI]). RESULTS: Patients were 28 to 68 (46 +/- 12) years old; 28 (70%) were male. Preoperatively, clinical assessment scores (median +/- interquartile range) were as follows: ESS (11.0 +/- 3.0), VAS (8.15 +/- 1.00), AHI (9.58 +/- 5.58), HI (9.00 +/- 5.29), AI (0.333 +/- 0.625). After CAUP, no postoperative scarring, fibrosis, or any other clinically significant side effects were observed. Postoperatively (9.1 +/- 1.5; 7-15 mo), ESS (4.0 +/- 1.0), VAS (2.70 +/- 1.38), AHI (3.75 +/- 2.92), HI (3.58 +/- 2.50), and AI (0.167 +/- 0.167) were significantly improved (P < .001). CONCLUSION: CAUP preceded by site-specific obstruction diagnosis using pressure recording is a well-tolerated outpatient treatment that is well suited for treating SRBD.
Authors:
Magne Tvinnereim; Svetislav Mitic; Rolf K Hansen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Laryngoscope     Volume:  117     ISSN:  0023-852X     ISO Abbreviation:  Laryngoscope     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-04-06     Completed Date:  2007-05-17     Revised Date:  2008-06-24    
Medline Journal Info:
Nlm Unique ID:  8607378     Medline TA:  Laryngoscope     Country:  United States    
Other Details:
Languages:  eng     Pagination:  731-6     Citation Subset:  IM    
Affiliation:
EuroSleep, Bergen, Norway. mt@eursleep.no
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MeSH Terms
Descriptor/Qualifier:
Adult
Catheter Ablation / instrumentation*
Disorders of Excessive Somnolence / diagnosis,  epidemiology
Female
Humans
Male
Middle Aged
Otorhinolaryngologic Surgical Procedures / methods
Palate, Soft / surgery
Pharynx / surgery
Severity of Illness Index
Sleep Apnea Syndromes / blood*,  epidemiology,  surgery*
Sleep Apnea, Obstructive / diagnosis,  epidemiology
Snoring / diagnosis,  epidemiology
Uvula / surgery
Comments/Corrections
Comment In:
Laryngoscope. 2007 Dec;117(12):2260-1; author reply 261   [PMID:  18322426 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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