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Radiofrequency Tissue Volume Reduction
Multilesion vs Single-Lesion Treatments for Snoring
Michael Ferguson, MD;
Timothy L. Smith, MD, MPH;
Adam M. Zanation;
Wendell G. Yarbrough, MD
Arch Otolaryngol Head Neck Surg. 2001;127:1113-1118.
Objective To compare the safety and efficacy of single-lesion and multilesion
radiofrequency tissue reduction (RFTR) of the soft palate for the treatment
of snoring.
Design Prospective, nonrandomized clinical trial.
Setting University hospital outpatient clinic.
Patients Nonrandomized patients undergoing RFTR to treat socially unacceptable
snoring. Of 47 patients, 16 received single-lesion treatments and 31 received
multilesion treatments.
Intervention Soft-palate RFTR was performed using a radiofrequency generator. Patients
required 1 to 3 treatments based on improvement or withdrawal from the study,
and each received 1, 3, or 4 lesions per treatment. Patients who received
single-lesion therapy did not cross over into the multilesion group; however,
5 patients in the multilesion group received 4-lesion therapy after a treatment
with 3 lesions.
Main Outcome Measures Outcome measures were determined using visual analog scale questionnaires
assessing level of snoring (snoring index) and level of pain (pain index)
associated with the procedure. Adverse events and complications during treatment
were cataloged. Data were collected before the procedure, 6 weeks after each
treatment, and an average of 16 months after the last procedure.
Results Single-lesion and multilesion groups showed significant improvement
in snoring after RFTR treatments (P<.01 for both).
However, compared with the single-lesion group, the multilesion group required
fewer treatments (1.94 vs 2.38; P = .05) and was
more than twice as likely to be cured after 2 treatments (61% vs 25%; P = .02). A trend toward improved clinical outcomes with
increased number of lesions and total energy per treatment was observed when
patients treated with 1, 3, or 4 lesions were compared. The 4-lesion group
had the most pronounced improvement in snoring index score per treatment,
the lowest number of treatments required for cure, and the greatest percentage
of patients cured after 2 treatment sessions. Follow-up demonstrated minimal
relapse of snoring in the multilesion group at a mean of 16 months. Although
there was a statistically significant increase in pain in the multilesion
group vs the single-lesion group, this increase did not increase narcotic
use or time off work and was considered minimal by reporting patients.
Conclusion Multilesion RFTR using higher energy levels per treatment is safe and
has increased efficacy without increased complications relative to single-lesion
therapy.
From the Division of Otolaryngology/Head and Neck Surgery, Department
of Surgery (Drs Ferguson and Yarbrough and Mr Zanation), the Department of
Biochemistry and Biophysics (Dr Yarbrough), and the Lineberger Comprehensive
Cancer Center (Dr Yarbrough), University of North Carolina School of Medicine,
Chapel Hill; and the Department of Otolaryngology, Medical College of Wisconsin,
Milwaukee (Dr Smith).
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Archives of Otolaryngology–Head & Neck Surgery Reader's Choice: Continuing Medical Education
Arch Otolaryngol Head Neck Surg. 2001;127(9):1146-1148.
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