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The impact of pretreatment assessment of oropharynx on interstitial soft palate radiofrequency surgery outcome-a multi-center study in patients with habitual snoring.

08:31 EDT 20th June 2013 | BioPortfolio

Summary of "The impact of pretreatment assessment of oropharynx on interstitial soft palate radiofrequency surgery outcome-a multi-center study in patients with habitual snoring."


PURPOSE:
Interstitial radiofrequency (RF) surgery of the soft palate (SP) is an established option in the treatment of habitual snoring. The decision-making process in the management of habitual snoring would benefit from diagnostic guidelines for oropharyngeal findings. Our aim was to investigate the correlation of systematic clinical pretreatment oropharyngeal examination scores with the efficacy of interstitial RF surgery of SP in a multi-center study.
METHODS:
Seventy-four patients (58 (78%) males and 16 (22%) females) with the median age of 42 years (range, 23-64), pre-treatment BMI of 25.6 kg/m(2) (range, 20.0-28.0), and preoperative AHI of three events/h (range, 0-10), received a single session of RF surgery. Thirty-two, five, 16, and 21 patients, respectively, were treated at the participating centers with a follow-up time of 13 weeks (range 12-16). The primary outcome measure was the efficacy of the treatment on snoring assessed by the patient and the bed partner with visual analog scale (VAS).
RESULTS:
The snoring showed a significant change demonstrating decreased snoring (VASpatpre 7 (range, 5-10) ≥VASpatpost 4.25 (range, 1-8), P < 0.001, VASbedppre 8 (range, 4-10) ≥VASbedppost 5 (range, 1-10), P < 0.001). Twenty-one patients (28.4%) experienced a successful treatment outcome. The increased grade of the uvula had a negative impact on the snoring results.
CONCLUSION:
Systematic clinical pretreatment oropharyngeal examination scores showed that the increasing grade of the uvula correlated significantly with the short-term post-treatment change in snoring. We suggest that patients with habitual snoring and uvula grade III should be initially treated with SP interstitial RF surgery and concomitant uvular surgery. A grading tool is proposed for oropharyngeal examination to help in the most appropriate treatment decision for each individual snoring patient.

Affiliation

Departments of Otorhinolaryngology-Head and Neck Surgery, Helsinki University Central Hospital and University of Helsinki, P.O. Box 220, 00029, HUCH, Helsinki, Finland, leif.back@helsinki.fi.

Journal Details

This article was published in the following journal.

Name: Sleep & breathing = Schlaf & Atmung
ISSN: 1522-1709
Pages:

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Medical and Biotech [MESH] Definitions

Oropharynx

The middle portion of the pharynx that lies posterior to the mouth, inferior to the SOFT PALATE, and superior to the base of the tongue and EPIGLOTTIS. It has a digestive function as food passes from the mouth into the oropharynx before entering ESOPHAGUS.

Palate

The structure that forms the roof of the mouth. It consists of the anterior hard palate (PALATE, HARD) and the posterior soft palate (PALATE, SOFT).

Palatine Tonsil

A round-to-oval mass of lymphoid tissue embedded in the lateral wall of the PHARYNX. There is one on each side of the oropharynx in the fauces between the anterior and posterior pillars of the SOFT PALATE.

Palatal Neoplasms

Tumors or cancer of the PALATE, including those of the hard palate, soft palate and UVULA.

Cleft Palate

Congenital fissure of the soft and/or hard palate, due to faulty fusion.

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