Radiofrequency Volumetric Tissue Reduction in the Treatment of Sleep Disordered Breathing: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

HU Chunmei ¹ , LIANG Chuanyu ¹ , WU Taixiang ²

1. Department of Otolarygnology, West China Hospital, Sichuan University, Chengdu 410041, China2. Chinese Evidence-Based Medicine and Clinical Epidemiology Center, West China Hospital, Sichuan University, Chengdu 410041, China;

Corresponding author：

Keywords：

Radiofrequency treatment; Radiofrequency volumetric tissue reduction; Sleep disordered breathing; Systematic review

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Objective 　To evaluate the effectiveness ofradiofrequency volumetric tissue reduction （RFVTR） in the treatment of sleep disordered breathing （SDB ）.
Methods 　We searched The Cochrane Central Register of Controlled Trials （Issue 1, 2005）, MEDLINE （1966 to Apr. 2005）, EMBASE （1989 to Apr. 2005）, CINAHL （1982 to Dec. 2000）, VIP （1989 to Dec. 2004） , CJFD （1979 to 2005）, WANFANG DATA （1977 to 2004） , and CBMdisc （1978 to 2005）. The bibliographies of all papers retrieved in full text form and relevant narrative reviews were searched for additional publications. All randomized controlled clinical trials （RCT） or quasi-randomized controlled trials （quasi-RCT） or prospective cohort studies of RFVTR alone or in combination with other treatments compared with placebo or other treatments were included. Data were extracted independently from the trial reports by the two authors. Meta-analysis was performed using RevMan software.
Results 　There were 11 studies including 540 patients met the inclusion criteria for this review, among which five were RCTs, six were prospective cohort studies, and all trials were of lower methodological quality. RFVTR showed benefit over placebo in apnea index （AI）, but this benefit was not seen in other polysorrmography （PSG） parameters, symptom and quality of life, psychomotor vigilance pain, swallowing difficulty and adverse events. Compared with continuous positive airway pressure （CPAP）, uvulopalatopharyngoplasty （UPPP） and laser assisted uvulopalatoplasty （LAUP） , RFVTR was more effective in psychomotor vigilance pain and swallowing difficulty, but this effect was not seen in PSG parameters, symptom and quality of life.
Conclusions 　RFVTR is more effective than placebo in AI improvement and other treatments in decreasing postoperative pain and other adverse events ; but this benefit was not seen in improving quality of sleeping and life. More well-designed randomized trials need to be conducted to identify the effectiveness and the influence on effectiveness of severity and frequency of treatment.

Citation： HU Chunmei,LIANG Chuanyu,WU Taixiang. Radiofrequency Volumetric Tissue Reduction in the Treatment of Sleep Disordered Breathing: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2005, 05(11): 846-853. doi: Copy

1.	李福军.睡眠障碍性呼吸的研究进展[J]国外医学.耳鼻咽喉科学分册,2001;5:265～271.
2.	徐欣,姬红岩.睡眠呼吸紊乱[J].山东医大基础医学院学报,2000;14(4):242～243.
3.	蒋珏,卢哓峰.阻塞性睡眠呼吸暂停综合征的射频温控减容治疗[J].上海口腔医学,2002;11(3):265-267.
4.	王璋,司良毅.射频治疗鼾症和阻塞性睡眠呼吸暂停综合征的进展[J].中国医师杂志,2004;6(2):284～285.
5.	Li FJ. Progress of Sleep disordered Breathing [J]. Foreign MedicineOtolaryngology, 2001; 25 (5): 265-271.
6.	Xu X, Ji HY. Sleep Disordered Breathing [J]. J Preclin Med Coll Shandong Med Univ, 2000; 14(4): 242-243.
7.	Littlefield PD, Mair EA. Snoring surgery: which one is best for you[J] ?Ear, Nose, & Throat Journal, 1999; 78(11): 861-865,868-870.
8.	Jiang J, Lu XF. Radiofrequency Volumetric Tissue Reduction for Obstructive Sleep Apnea Syndrome [J]. Shanghai Journal of Stomatology, 2002; 11 (3): 265-267.
9.	Wang Z, Si LY. Progress of Radiofrequency for Snoring and Obstructive Sleep Apnea Syndrome [J]. Journal of Chinese Physician,2004; 6(2): 284 -285.
10.	Alderson P, Green S, Higgins JPT, editors. Cochrane Reviewers’Handbook 4. 2. 1 [updated December 2003]. Section 6. In: The Cochrane Library. The Cochrane Collaboration. Oxford: 2004, Issue 1.
11.	Woodson BT, Steward DL, Weaver EM, Javaheri S. A randomized trial of temperature-controlled radiofrequency, continuous positive airway pressure, and placebo for obstructive sleep apnea syndrome [J].Otolaryngology-Head & Neck Surgery, 2003; 128 (6): 848-861.
12.	Terris DJ, Coker JF, Thomas AJ, Chavoya M. Preliminary findings from a prospective, randomized trial of two palatal operations for sleepdisordered breathing[J]. Otolaryngology-Head & Neck Surgery, 2002; 127(4): 315-323.
13.	Steward DL, Weaver EM, Woodson BT. A comparison of radiofrequency treatment schemes for obstructive sleep apnea syndrome[J]. Otolaryngology-Head & Neck Surgery, 2004; 130(5): 579-585.
14.	Powell NB, Zonato Al, Weaver EM, Li K, Troell R, Riley RW,Guilleminault C. Radiofrequency treatment of turbinate hypertrophy in subjects using continuous positive airway pressure: a randomized, doubleblind, placebo-controlled clinical pilot trial [J]. Laryngoscope, 2001; 111(10): 1783-1790.
15.	Hultcrantz E, Ericsson E. Pediatric tonsillotomy with the radiofrequency technique: less morbidity and pain[J]. Laryngoscope, 2004; 114(5): 871-877.
16.	Cartwright R, Venkatesan TK, Caldarelli D, Diaz F. Treatments for snoring: a comparison of somnoplasty and an oral apphance[J].Laryngoscope, 2000; 110(10 Pt 1): 1680-1683.
17.	Rombaux P, Hamoir M, Bertrand B, Aubert G, Liistro G, R odenstein D. Postoperative pain and side effects after uvulopalatopharyngoplasty,laser-assisted uvulopalatoplasty, and radiofrequency tissue volume reduction in primary snoring[J]. Laryngoscope, 2003; 113 (12): 2169-2173.
18.	Blumen MB, Dahan S, Wagner I, De Dieuleveult T, Chabolle F.Radiofrequency versus LAUP for the treatment of snoring [J].Otolaryngology-Head & Neck Surgery, 2002; 126(1): 67-73.
19.	Troell RJ, Powell NB, Riley RW, Li KK, Guilleminault C.Comparison of postoperative pain between laser-assisted uvulopalatoplasty,uvulopalatopharyngoplasty, and radiofrequency volumetric tissue reduction of the palate [J]. Otolaryngology-Head & Neck Surgery, 2000; 122 (3):402-409.
20.	Woodson BT, Nelson L, Mickelson S, Huntley T, Sher A. A multiinstitutional study of radiofrequency volumetric tissue reduction for OSAHS[J]. Otolaryngology-H1ead & Neck Surgery, 2001; 125(4): 303-311.
21.	Nelson LM. Combined temperature-controlled radiofrequency tongue reduction and UPPP in apnea surgery[J]. Ear, Nose, & Throat Journal,2001; 80(9): 640-644.

1. 李福军.睡眠障碍性呼吸的研究进展[J]国外医学.耳鼻咽喉科学分册,2001;5:265～271.
2. 徐欣,姬红岩.睡眠呼吸紊乱[J].山东医大基础医学院学报,2000;14(4):242～243.
3. 蒋珏,卢哓峰.阻塞性睡眠呼吸暂停综合征的射频温控减容治疗[J].上海口腔医学,2002;11(3):265-267.
4. 王璋,司良毅.射频治疗鼾症和阻塞性睡眠呼吸暂停综合征的进展[J].中国医师杂志,2004;6(2):284～285.
5. Li FJ. Progress of Sleep disordered Breathing [J]. Foreign MedicineOtolaryngology, 2001; 25 (5): 265-271.
6. Xu X, Ji HY. Sleep Disordered Breathing [J]. J Preclin Med Coll Shandong Med Univ, 2000; 14(4): 242-243.
7. Littlefield PD, Mair EA. Snoring surgery: which one is best for you[J] ?Ear, Nose, & Throat Journal, 1999; 78(11): 861-865,868-870.
8. Jiang J, Lu XF. Radiofrequency Volumetric Tissue Reduction for Obstructive Sleep Apnea Syndrome [J]. Shanghai Journal of Stomatology, 2002; 11 (3): 265-267.
9. Wang Z, Si LY. Progress of Radiofrequency for Snoring and Obstructive Sleep Apnea Syndrome [J]. Journal of Chinese Physician,2004; 6(2): 284 -285.
10. Alderson P, Green S, Higgins JPT, editors. Cochrane Reviewers’Handbook 4. 2. 1 [updated December 2003]. Section 6. In: The Cochrane Library. The Cochrane Collaboration. Oxford: 2004, Issue 1.
11. Woodson BT, Steward DL, Weaver EM, Javaheri S. A randomized trial of temperature-controlled radiofrequency, continuous positive airway pressure, and placebo for obstructive sleep apnea syndrome [J].Otolaryngology-Head & Neck Surgery, 2003; 128 (6): 848-861.
12. Terris DJ, Coker JF, Thomas AJ, Chavoya M. Preliminary findings from a prospective, randomized trial of two palatal operations for sleepdisordered breathing[J]. Otolaryngology-Head & Neck Surgery, 2002; 127(4): 315-323.
13. Steward DL, Weaver EM, Woodson BT. A comparison of radiofrequency treatment schemes for obstructive sleep apnea syndrome[J]. Otolaryngology-Head & Neck Surgery, 2004; 130(5): 579-585.
14. Powell NB, Zonato Al, Weaver EM, Li K, Troell R, Riley RW,Guilleminault C. Radiofrequency treatment of turbinate hypertrophy in subjects using continuous positive airway pressure: a randomized, doubleblind, placebo-controlled clinical pilot trial [J]. Laryngoscope, 2001; 111(10): 1783-1790.
15. Hultcrantz E, Ericsson E. Pediatric tonsillotomy with the radiofrequency technique: less morbidity and pain[J]. Laryngoscope, 2004; 114(5): 871-877.
16. Cartwright R, Venkatesan TK, Caldarelli D, Diaz F. Treatments for snoring: a comparison of somnoplasty and an oral apphance[J].Laryngoscope, 2000; 110(10 Pt 1): 1680-1683.
17. Rombaux P, Hamoir M, Bertrand B, Aubert G, Liistro G, R odenstein D. Postoperative pain and side effects after uvulopalatopharyngoplasty,laser-assisted uvulopalatoplasty, and radiofrequency tissue volume reduction in primary snoring[J]. Laryngoscope, 2003; 113 (12): 2169-2173.
18. Blumen MB, Dahan S, Wagner I, De Dieuleveult T, Chabolle F.Radiofrequency versus LAUP for the treatment of snoring [J].Otolaryngology-Head & Neck Surgery, 2002; 126(1): 67-73.
19. Troell RJ, Powell NB, Riley RW, Li KK, Guilleminault C.Comparison of postoperative pain between laser-assisted uvulopalatoplasty,uvulopalatopharyngoplasty, and radiofrequency volumetric tissue reduction of the palate [J]. Otolaryngology-Head & Neck Surgery, 2000; 122 (3):402-409.
20. Woodson BT, Nelson L, Mickelson S, Huntley T, Sher A. A multiinstitutional study of radiofrequency volumetric tissue reduction for OSAHS[J]. Otolaryngology-H1ead & Neck Surgery, 2001; 125(4): 303-311.
21. Nelson LM. Combined temperature-controlled radiofrequency tongue reduction and UPPP in apnea surgery[J]. Ear, Nose, & Throat Journal,2001; 80(9): 640-644.

Chinese Journal of Evidence-Based Medicine

Radiofrequency Volumetric Tissue Reduction in the Treatment of Sleep Disordered Breathing: A Systematic Review

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