Radiofrequency tissue volume reduction - Multilesion vs single-lesion treatments for snoring

Objective: To compare the safety and efficacy of single-lesion and multiles ion radiofrequency tissue reduction (RFTR) of the soft palate for the treat ment of snoring. Design: Prospective, nonrandomized clinical trial. Setting: University hospital outpatient clinic. Patients: Nonrandomized patients undergoing RFTR to treat socially unaccept able snoring. Of 47 patients, 16 received single-lesion treatments and 31 r eceived multilesion treatments. Intervention: Soft-palate RFTR was performed using a radiofrequency generat or. Patients required 1 to 3 treatments based on improvement or withdrawal from the study, and each received 1, 3, or 4 lesions per treatment. Patient s who received single-lesion therapy did not cross over into the multilesio n group; however, 5 patients in the multilesion group received 4-lesion the rapy 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 comp lications during treatment were cataloged. Data were collected before the p rocedure, 6 weeks after each treatment, and an average of 16 months after t he last procedure. Results: Single-lesion and multilesion groups showed significant improvemen t 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 w ith 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 treatm ent, the lowest number of treatments required for cure, and the greatest pe rcentage of patients cured after 2 treatment sessions. Follow-up demonstrat ed minimal relapse of snoring in the multilesion group at a mean of 16 mont hs. Although there was a statistically significant increase in pain in the multilesion group vs the single-lesion group, this increase did not increas e narcotic use or time off work and was considered minimal by reporting pat ients. Conclusion: Multilesion RFTR using higher energy levels per treatment is sa fe and has increased efficacy without increased complications relative to s ingle-lesion therapy.