Radiofrequency vs laser in the management of mild to moderate obstructive sleep apnoea: does the number of treatment sessions matter?

Atef, Ahmed; Mosleh, Mohammed; Hesham, Mohammed; Fathi, Ahmed; Hassan, Muhammed A.; Fawzy, Manal

doi:10.1258/002221505774783485

Cited by 26 publications

(15 citation statements)

References 19 publications

(32 reference statements)

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“…The CPAP studies included trials comparing CPAP versus sub-therapeutic (sham) CPAP [ 4 – 34 ], CPAP versus an oral placebo [ 33 , 35 – 43 ], CPAP versus conservative or no therapy [ 10 , 22 , 44 – 54 ], CPAP versus an oral appliance [ 4 , 5 , 36 , 51 , 55 – 63 ], CPAP versus postural therapy [ 64 – 67 ], and CPAP alone assessing different means to modify adherence (e.g., with vs. without a humidifying element) [ 8 , 21 , 30 , 68 – 79 ]. The surgical trials assessed a variety of single- and multi-stage procedures incorporating uvuloplasty [ 22 , 80 – 117 ], mandibular advancement [ 118 , 119 ], laser treatments [ 120 – 125 ], radiofrequency tissue reduction and other lingual procedures [ 117 , 125 – 134 ], and palate implants [ 135 – 141 ], in addition to five trials specifically evaluating the safety versus risks of OSA surgery, including its safety as an outpatient/same-day procedure [ 142 – 146 ]. The PRISMA charts seen in Figs.…”

Section: Resultsmentioning

confidence: 99%

Reconsidering first-line treatment for obstructive sleep apnea: a systematic review of the literature

Rotenberg

Vicini

Pang³

et al. 2016

J of Otolaryngol - Head & Neck Surg

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BackgroundContinuous positive airway pressure (CPAP) is typically recommended as first line therapy for obstructive sleep apnea, but the adherence rate of CPAP is problematic. This study’s objective was to systematically review the literature relating to CPAP as first line therapy for OSA and compare it to surgical literature on the same topic.MethodsA systematic review was conducted according to PRISMA guidelines, examining Medline-Ovid, Embase, and Pubmed databases. The primary search objective was to identify all papers reporting the results of (1) randomized clinical trials (RCT) of CPAP for the treatment of adults with OSA; and (2) both randomized and non-randomized clinical trials and case series on the surgical treatment of OSA in adults. A PhD-level biostatistician first screened papers, and then those that met study criteria were retrieved and analyzed using standardized forms for each author. The primary outcomes were adherence rates of CPAP.ResultsA total of 82 controlled clinical trials for CPAP and 69 controlled and non-controlled surgery trials were identified for analysis. Variation in CPAP use within reported RCT trials were identified, and the majority of patients in the studies would eventually be considered non-adherent to CPAP.ConclusionsWhen considering the numerous patient-related factors that come into play when CPAP is prescribed, the concept of CPAP as gold-standard therapy for OSA should be reconsidered. In many cases surgery can provide a better overall outcome. This study’s results suggest that certain patients with OSA may be managed more effectively with surgery than CPAP, without confounding issues of treatment adherence.Electronic supplementary materialThe online version of this article (doi:10.1186/s40463-016-0136-4) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Reconsidering first-line treatment for obstructive sleep apnea: a systematic review of the literature

Rotenberg

Vicini

Pang³

et al. 2016

J of Otolaryngol - Head & Neck Surg

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“…In the study by Atef et al [39], there was a mean reduction of AHI from 26.3 to 16.6 after 18 months in the RF-UPP group (n = 64). Seventy-five patients that were treated with a standard LAUP were used as control.…”

Section: Rf-uppmentioning

confidence: 87%

ENT-specific therapy of obstructive sleep apnoea in adults

et al. 2016

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The German Society of Otorhinolaryngology, Head and Neck Surgery recently has released the abbreviated version of its scientific guideline "ENT-specific therapy of obstructive sleep apnoea (OSA) in adults", which has been updated in 2015 and can be found online at the Association of the Scientific Medical Societies (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften, AWMF). A summary of the main recommendations is provided in this revised English version. All recommendations are based on a systematic literature research of articles published up until March 2014. Literature research followed the Cochrane Handbook for Systematic Literature Research to create Guidelines published by the German Cochrane Centre. Studies were evaluated with respect to their scientific value according to the recommendations of the Oxford Centre for Evidence-based Medicine, and grades of recommendation are provided regarding each intervention.

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“…Atef et al compared the use of radiofrequency versus laser-assisted uvulopalatoplasty for obstructive sleep apnoea. They concluded that both treatments required multiple treatments, but radiofrequency appeared to have a more sustained long-term outcome [20]. Back et al reviewed the use of radiofrequency in snoring surgery and identified that the symptoms of snoring were reduced in the short-term, but long-term data was lacking [13].…”

Section: Soft Palatementioning

confidence: 99%

Minimally Invasive Radiofrequency Surgery in Sleep-Disordered Breathing

Patel

Kotecha

2019

Healthcare

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Sleep-disordered breathing encompasses a spectrum of conditions ranging from simple snoring to obstructive sleep apnoea (OSA). Radiofrequency surgery represents a relatively new technique available to surgeons involved in managing this condition. Its principal advantage relates to its minimally invasive nature resulting in a reduced morbidity when compared to traditional sleep surgery. The presence of good-quality research evaluating the long-term outcomes is currently scarce, although the short-term data is promising. Careful patient selection appears to be paramount in obtaining a sustained improvement. The role of radiofrequency surgery in sleep-disordered breathing has been reviewed.

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Radiofrequency vs laser in the management of mild to moderate obstructive sleep apnoea: does the number of treatment sessions matter?

Cited by 26 publications

References 19 publications

Reconsidering first-line treatment for obstructive sleep apnea: a systematic review of the literature

Reconsidering first-line treatment for obstructive sleep apnea: a systematic review of the literature

ENT-specific therapy of obstructive sleep apnoea in adults

Minimally Invasive Radiofrequency Surgery in Sleep-Disordered Breathing

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