Long-term safety and efficacy of radiofrequency ablation in the treatment of sleep disordered breathing: a meta-analysis

Abstract

Radiofrequency ablation (RFA) is used in the treatment of sleep disordered breathing (SDB), particularly in the alleviation of snoring. The literature provides evidence that the short-term results are promising; however, the long-term efficacy is a matter of contention. In this article, we present the results of a literature search of studies that use RFA in the treatment of SDB which have a follow-up time of greater than a year. RFA was found to be a safe technique with minimal morbidity. The overall Visual Analogue score from six studies showed the overall mean improvement to be 4.3 (confidence intervals 3.4-5.12). Apnea Hypopnea Index (AHI), improved significantly in five of the studies analysed. Epworth Sleepiness Score (ESS), improved significantly in six of the studies analysed. In conclusion, the evidence suggests that RFA for SDB results in a significant improvement in follow-up times of at least a year. Since RFA can be applied in a clinic setting and leads to minimal disruption to daily life, this treatment option can be considered for those unwilling to participate in the more traditional surgical options for SDB.

When continuous positive airway pressure (CPAP) fails

“…Currently, radiofrequency applications to the soft palate have shown promising long-term efficacy and has been approved by NICE in the UK (57). Repeat procedures may be required but complication rates are low (58). Additional tonsillectomy may also be beneficial either at a primary or secondary stage, depending on clinical findings and DISE evaluation.…”

Tailoring surgical interventions to treat obstructive sleep apnoea: one size does not fit all

“…tonsillectomy and resection of redundant tonsillar pillars, or shortening of uvula. Repeat applications may be required, but nevertheless complication rates remain low [ 41 ]. These include mucosal ulceration, although abscess/fistula has also been reported.…”

Minimally Invasive Radiofrequency Surgery in Sleep-Disordered Breathing

“…This subsequently causes local tissue heating, cell necrosis, and scarring. Histological studies have identified that the lesion spreads from the probe to an 8mm circumference [4]. This has the distinct advantage of providing therapeutic tissue necrosis in the interstitial layer but keeping the mucosal layer largely unaffected.…”

“…Radiofrequency can be used to fibrose tissue but also as a cutting technique with minimal collateral damage [6]. Radiofrequency acts without stimulating nerves and muscle, which allows it to be used without general anaesthetic in the clinic setting [4].…”