Comparative Effects of Snoring Sound between Two Minimally Invasive Surgeries in the Treatment of Snoring: A Randomized Controlled Trial

Abstract

BackgroundMinimally invasive surgeries of the soft palate have emerged as a less-invasive treatment for habitual snoring. To date, there is only limited information available comparing the effects of snoring sound between different minimally invasive surgeries in the treatment of habitual snoring.ObjectiveTo compare the efficacy of palatal implant and radiofrequency surgery, in the reduction of snoring through subjective evaluation of snoring and objective snoring sound analysis.Patients and MethodThirty patients with habitual snoring due to palatal obstruction (apnea-hypopnea index ≤15, body max index ≤30) were prospectively enrolled and randomized to undergo a single session of palatal implant or temperature-controlled radiofrequency surgery of the soft palate under local anesthesia. Snoring was primarily evaluated by the patient with a 10 cm visual analogue scale (VAS) at baseline and at a 3-month follow-up visit and the change in VAS was the primary outcome. Moreover, life qualities, measured by snore outcomes survey, and full-night snoring sounds, analyzed by a sound analytic program (Snore Map), were also investigated at the same time.ResultsTwenty-eight patients completed the study; 14 received palatal implant surgery and 14 underwent radiofrequency surgery. The VAS and snore outcomes survey scores were significantly improved in both groups. However, the good response (postoperative VAS ≤3 or postoperative VAS ≤5 plus snore outcomes survey score ≥60) rate of the palatal implant group was significantly higher than that of the radiofrequency group (79% vs. 29%, P = 0.021). The maximal loudness of low-frequency (40–300 Hz) snores was reduced significantly in the palatal implant group. In addition, the snoring index was significantly reduced in the radiofrequency group.ConclusionsBoth palatal implants and a single-stage radiofrequency surgery improve subjective snoring outcomes, but palatal implants have a greater effect on most measures of subjective and objective snoring. Multi-stage radiofrequency surgery was not tested.Trial RegistrationClinicalTrials.gov NCT01955083

Therapeutic outcomes of mandibular advancement devices as an initial treatment modality for obstructive sleep apnea

“…[6,16] Effective treatment of OSA requires maintenance of upper airway patency during sleep, which can be achieved through several modalities, including invasive and noninvasive interventions. [17–25] For the treatment of OSA, there are several options from nonsurgical approaches such as weight control and intranasal space maintaining to surgical approaches including palatopharyngoplasty. [26] CPAP is the current mainstay of noninvasive therapy for OSA and is an effective treatment that has been shown to reduce apnea or hypopnea, subjective sleep-related symptoms, and attenuate cardiovascular complications.…”

Effects of Oropharyngeal Exercises on Snoring

“…We used a similar distance of the microphone to the patient (1 m) 34,35 and adopted the snore index to express our results as previously reported. 34,[36][37][38] In addition, we used the total snore index to represent the total snore intensity power generated during sleep. Th e objective reduction in snore indexes among patients randomized to oropharyngeal exercises occurred in conjunction with an improvement in the perceived snoring evaluated by the bed partner.…”

Changes of snoring sound after relocation pharyngoplasty for obstructive sleep apnoea: the surgery reduces mean intensity in snoring which correlates well with apnoea–hypopnoea index

“…Serial procedures of laser‐assisted uvulopalatoplasty also significantly decrease the maximum, average and velum‐like respiratory noise loudness assessed by SNAP testing system . Palatal implants can mainly reduce the B1‐maximal sound intensity . However, there is no difference in snoring intensity after one‐stage laser‐assisted uvulopalatoplasty surgery and between laser surgery and sham surgery …”

“…11 Palatal implants can mainly reduce the B1-maximal sound intensity. 22 However, there is no difference in snoring intensity after one-stage laser-assisted uvulopalatoplasty surgery and between laser surgery and sham surgery. 23 In this study, the mean intensity of snoring sound decreased significantly in the total and in all three bands postoperatively.…”