Radiofrequency Ablation Versus Bipolar Electrocautery for the Treatment of Nasal Obstruction in Obstructive Sleep Apnea Patients Using Continuous Positive Airway Pressure
DOI:
https://doi.org/10.31584/jhsmr.2020749Keywords:
bipolar electrocautery, CPAP, nasal obstruction, obstructive sleep apnoea, radiofrequency ablationAbstract
Objective: To investigate the treatment effect of radiofrequency ablation (RFA) on nasal obstruction, continuous positive airway pressure (CPAP) compliance, Epworth sleepiness scale (ESS) and sleep quality were compared with that of bipolar electrocautery (BEC) in patients using CPAP.
Material and Methods: Participants were randomised into two groups and treated with either RFA or BEC. Data were collected regarding nasal obstruction, total nasal symptoms, CPAP compliance, daytime sleepiness and sleep quality before and after treatment at 1, 3 and 6 months.
Results: Twenty-eight patients were enrolled in the study. Both methods relieved nasal obstruction at 1, 3 and 6 months. At 6 months, the symptom was improved by 83.4% and 64.2% in the RFA and BEC groups, respectively. The total nasal symptoms decreased at 3 and 6 months in both groups as well, exhibiting 75.7% and 40.6% improvement at 6 months in the RFA and BEC groups, respectively.
Conclusion: Both RFA and BEC have the ability to relieve nasal obstruction in such patients.
References
1.Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 1993;328:1230–5.
2.Neruntarat C, Chantapant S. Prevalence of sleep apnea in HRH Princess Maha Chakri Sirinthorn Medical Center, Thailand. Sleep Breath 2011;15:641–8.
3.Terran-Santos J, Jimenez-Gomez A, Cordero-Guevara J. The association between sleep apnea and the risk of traffic accidents. N Engl J Med 1999;340:847–51.
4.Martin JM, Carrizo SJ, Vicente E, Agusti GA. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet 2005;365:1046–53.
5.Yaggi HK, Concato J, Kernan WN, Lichtman JH, Brass LM, Mohsenin V. Obstructive sleep apnea as a risk factor for stroke and death. N Engl J Med 2005;353:2034–41.
6.Marshall NS, Wong KK, Liu PY, Cullen SR, Knuiman MW, Grunstein RR. Sleep apnea as an independent risk factor for all-cause mortality: the Busselton Health Study. Sleep 2008;31:1079–85.
7.Young T, Finn L, Peppard PE, Szklo-Coxe M, Austin D, Nieto FJ, et al. Sleep disordered breathing and mortality: eighteenyear follow-up of the wisconsin sleep cohort. Sleep 2008;31: 1071–8.
8.Kushida CA, Littner MR, Hirshkowitz M, Morgenthaler MI, Alessi CA, Bailey D, et al. Practice parameters for the use of continuous and bilevel positive airway pressure devices to treat adult patients with sleep-related breathing disorders. Sleep 2006;29:375–80.
9.Giles TL, Lasserson TJ, Smith BJ, White J, Wright J, Cates CJ. Continuous positive airways pressure for obstructive sleep apnoea in adults. Cochrane Database Syst Rev 2006;1:1–15.
10.Staevska MT, Mandajieva MA, Dimitrov VD. Rhinitis and sleep apnea. Curr Allergy Asthma Rep 2004;4:193–9
11.Li H, Engleman H, Hsu C, Izci B, Vennelle M, Cross M, et al. Acoustic reflection for nasal airway measurement in patients with obstructive sleep apnea-hypopnea syndrome. Sleep 2005;28:1554–9.
12.Egan KK, Kezirian EJ, Kim DW. Nasal obstruction and sleep disordered breathing. Oper Tech Otolayngol 2006;17:268–72.
13.Janson C, Noges E, Svedberg-Brandt S, Linberg E. What characterizes patients who are unable to tolerate continuous positive airway pressure (cpap) treatment?. Resp Med 2000; 94:145–9.
14.Zozula R, Rosen R. Compliance with continuous positive airway pressure therapy: assessing and improving treatment outcomes. Curr Opin Pulm Med 2001;7:391–8.
15.Mickelson SA. Medical management and definition of continuous positive airway pressure failure. Oper Tech Otolaryngol Head Neck Surg 2006;17:216–22.
16.Mador MJ, Krauza M, Pervez A, Pierce D, Braun M. Effect of heated humidification on compliance and quality of life in patients with sleep apnea using nasal continuous positive airway pressure. Chest 2005;128:2151–8
17.Martins De Araujo MT, Vieira SB, Vasquez EC, Fleury B. Heated humidification or face mask to prevent upper airway dryness during continuous positive airway pressure therapy. Chest 2000;117:142–7.
18.Winck JC, Delgado JL, Almeida JM, Marques JA. Heated humidification during nasal continuous positive airway pressure for obstructive sleep apnea syndrome: objective evaluation of efficacy with nasal peak inspiratory flow measurements. Am J Rhinol 2002;16:175–7.
19.Charakorn N, Hirunwiwatkul P, Chirakalwasan N, Chaitusaney B, Prakassajjatham M. The effects of topical nasal steroids on continuous positive airway pressure compliance in patients with obstructive sleep apnea: a systematic review and metaanalysis. Sleep Breath 2017;21:3–8.
20.Camacho M, Riaz M, Capasso R, Ruoff CM, Guilleminault C, Kushida CA. The effect of nasal surgery on continuous positive airway pressure device use and therapeutic treatment pressures: a systemic review and meta-analysis. Sleep 2015; 38:279–86.
21.Sufioglu M, Ozmen OA, Kasapoglu F, Demir UL, Ursavas A, Erisen L, et al. The efficacy of nasal surgery in obstructive sleep apnea syndrome: a prospective clinical study. Eur Arch Otorhinolaryngol 2012;269:487–94.
22.Aurora RN, Casey KR, Kristo D, Auerbach S, Bista SR, Chowdhuri S, et al. Practice parameters for the surgical modifications of the upper airway for obstructive sleep apnea in adults. Sleep 2010;33:1408–13.
23.Powell NB, Zonato AI, Weaver EM, Li K, Troell R, Riley RW. Radiofrequency treatment of turbinate hypertrophy in subjects using continuous positive airway pressure: a randomized, double-blind, placebo-controlled clinical pilot trial. Laryngoscope 2001;111:1783–90.
24.Friedman M, Tanyeri H, Lim J, Landsberg R, Caldarelli D. A safe, alternative technique for inferior turbinate reduction. Laryngoscope 1999;109:1834–7.
25.Banhiran W, Assanasen P, Nopmaneejumruslers C, Metheetrairut C. Epworth sleepiness scale disordered breathing: the reliability and validity of the Thai version. Sleep Breath 2011;15: 571–7.
26.Banhiran W, Assanasen P, Metheetrairut C, Nopmaneejumruslers C, Chotinaiwattarakul W, Kerdnoppakhun J. Functional outcomes of sleep in thai patients with obstructive sleep-disordered breathing. Sleep Breath 2012;16:663–75.
27.Wolkove N, Baltzan M, Kamel H, Dabrusin R, Palayew M. Long-term compliance with continuous positive airway pressure in patients with obstructive sleep apnea. Can Respir J 2008;15: 365–9.
28.Sarrell EM, Chomsky O, Shechter D. Treatment compliance with continuous positive airway pressure device among adults with obstructive sleep apnea (OSA): how many adhere to treatment? Harefuah 2013;152:140–4.
29.Fischer Y, Gosepath J, Amedee RG, Mann WJ. Radiofrequency volumetric tissue reduction (RFVTR) of inferior turbinates: a new method in the treatment of chronic nasal obstruction. Am J Rhinol 2000;14:355–60.
30.Porter MW, Hales NW, Nease CJ, Krempl GA. Long-term results of inferior turbinate hypertrophy with radiofrequency treatment: a new standard of care? Laryngoscope 2006;116:554–7.
31.Saulescu M, Sarafoleanu C. Surgery for nasal obstruction in inferior turbinate hypertrophy. Romanian Journal of Rhinology 2015;5:25–30.
32.Garzaro M, Pezzoli M, Landolfo V, Defilippi S, Giordano C, Pecorari G. Radiofrequency inferior turbinate reduction: longterm olfactory and functional outcomes. Otolaryngol Head Neck Surg 2012;146:146–50.
33.Hirunwiwatkul P, Aeumjaturapata S, Oraphin P. Results of temperature-controlled radiofrequency tissue volume reduction for the turbinate hypertrophy. J Med Assoc Thai 2004; 87(Suppl 2):S91–4.
34.Nease CJ, Krempl GA. Radiofrequency treatment of turbinate hypertrophy: a randomized, blinded, placebo-controlled clinical trial. Otolaryngol Head Neck Surg 2004;130:291–9.
35.Cavaliere M, Mottola G, Lemma M. Comparison of the effectiveness and safety of radiofrequency turbinoplasty and traditional surgical technique in treatment of inferior turbinate hypertrophy. Otolaryngol Head Neck Surg 2005;133: 972–8.
36.Utley DS, Goode RL, Hakim I. Radiofrequency energy tissue ablation for the treatment of nasal obstruction secondary to turbinate hypertrophy. Laryngoscope 1999;109:683–6.
37.Shah AN, Brewster D, Mitzen K, Mullin D. Radiofrequency coblation versus intramural bipolar cautery for the treatment of inferior turbinate hypertrophy. Ann Oto Rhinol Laryngol 2015; 124:691–7.
38.Uluyol S, Karakaya NE, Gur MH, Kilicaslan S, Kantarcioglu EO, Yagiz O, et al. Radiofrequency thermal ablation versus bipolar electrocautery for the treatment of inferior turbinate hypertrophy: comparison of efficacy and postoperative morbidity. Int Arch Otolarhinolaryngol 2016;20:2–5.
39.Banhiran W, Tantilipikorn P, Metheetrairut C, Assanasen P, Bunnag C. Quality of life in patients with chronic rhinitis after radiofrequency inferior turbinate reduction. J Med Assoc Thai 2010;93:950–60.
40.Kilavuz AE, Songu M, Ozkul Y, Ozturkcan S, Katilmis H. Radiofrequency versus electrocautery for inferior turbinate hypertrophy. J Craniofac Surg 2014;26:1998–2001.
2.Neruntarat C, Chantapant S. Prevalence of sleep apnea in HRH Princess Maha Chakri Sirinthorn Medical Center, Thailand. Sleep Breath 2011;15:641–8.
3.Terran-Santos J, Jimenez-Gomez A, Cordero-Guevara J. The association between sleep apnea and the risk of traffic accidents. N Engl J Med 1999;340:847–51.
4.Martin JM, Carrizo SJ, Vicente E, Agusti GA. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet 2005;365:1046–53.
5.Yaggi HK, Concato J, Kernan WN, Lichtman JH, Brass LM, Mohsenin V. Obstructive sleep apnea as a risk factor for stroke and death. N Engl J Med 2005;353:2034–41.
6.Marshall NS, Wong KK, Liu PY, Cullen SR, Knuiman MW, Grunstein RR. Sleep apnea as an independent risk factor for all-cause mortality: the Busselton Health Study. Sleep 2008;31:1079–85.
7.Young T, Finn L, Peppard PE, Szklo-Coxe M, Austin D, Nieto FJ, et al. Sleep disordered breathing and mortality: eighteenyear follow-up of the wisconsin sleep cohort. Sleep 2008;31: 1071–8.
8.Kushida CA, Littner MR, Hirshkowitz M, Morgenthaler MI, Alessi CA, Bailey D, et al. Practice parameters for the use of continuous and bilevel positive airway pressure devices to treat adult patients with sleep-related breathing disorders. Sleep 2006;29:375–80.
9.Giles TL, Lasserson TJ, Smith BJ, White J, Wright J, Cates CJ. Continuous positive airways pressure for obstructive sleep apnoea in adults. Cochrane Database Syst Rev 2006;1:1–15.
10.Staevska MT, Mandajieva MA, Dimitrov VD. Rhinitis and sleep apnea. Curr Allergy Asthma Rep 2004;4:193–9
11.Li H, Engleman H, Hsu C, Izci B, Vennelle M, Cross M, et al. Acoustic reflection for nasal airway measurement in patients with obstructive sleep apnea-hypopnea syndrome. Sleep 2005;28:1554–9.
12.Egan KK, Kezirian EJ, Kim DW. Nasal obstruction and sleep disordered breathing. Oper Tech Otolayngol 2006;17:268–72.
13.Janson C, Noges E, Svedberg-Brandt S, Linberg E. What characterizes patients who are unable to tolerate continuous positive airway pressure (cpap) treatment?. Resp Med 2000; 94:145–9.
14.Zozula R, Rosen R. Compliance with continuous positive airway pressure therapy: assessing and improving treatment outcomes. Curr Opin Pulm Med 2001;7:391–8.
15.Mickelson SA. Medical management and definition of continuous positive airway pressure failure. Oper Tech Otolaryngol Head Neck Surg 2006;17:216–22.
16.Mador MJ, Krauza M, Pervez A, Pierce D, Braun M. Effect of heated humidification on compliance and quality of life in patients with sleep apnea using nasal continuous positive airway pressure. Chest 2005;128:2151–8
17.Martins De Araujo MT, Vieira SB, Vasquez EC, Fleury B. Heated humidification or face mask to prevent upper airway dryness during continuous positive airway pressure therapy. Chest 2000;117:142–7.
18.Winck JC, Delgado JL, Almeida JM, Marques JA. Heated humidification during nasal continuous positive airway pressure for obstructive sleep apnea syndrome: objective evaluation of efficacy with nasal peak inspiratory flow measurements. Am J Rhinol 2002;16:175–7.
19.Charakorn N, Hirunwiwatkul P, Chirakalwasan N, Chaitusaney B, Prakassajjatham M. The effects of topical nasal steroids on continuous positive airway pressure compliance in patients with obstructive sleep apnea: a systematic review and metaanalysis. Sleep Breath 2017;21:3–8.
20.Camacho M, Riaz M, Capasso R, Ruoff CM, Guilleminault C, Kushida CA. The effect of nasal surgery on continuous positive airway pressure device use and therapeutic treatment pressures: a systemic review and meta-analysis. Sleep 2015; 38:279–86.
21.Sufioglu M, Ozmen OA, Kasapoglu F, Demir UL, Ursavas A, Erisen L, et al. The efficacy of nasal surgery in obstructive sleep apnea syndrome: a prospective clinical study. Eur Arch Otorhinolaryngol 2012;269:487–94.
22.Aurora RN, Casey KR, Kristo D, Auerbach S, Bista SR, Chowdhuri S, et al. Practice parameters for the surgical modifications of the upper airway for obstructive sleep apnea in adults. Sleep 2010;33:1408–13.
23.Powell NB, Zonato AI, Weaver EM, Li K, Troell R, Riley RW. Radiofrequency treatment of turbinate hypertrophy in subjects using continuous positive airway pressure: a randomized, double-blind, placebo-controlled clinical pilot trial. Laryngoscope 2001;111:1783–90.
24.Friedman M, Tanyeri H, Lim J, Landsberg R, Caldarelli D. A safe, alternative technique for inferior turbinate reduction. Laryngoscope 1999;109:1834–7.
25.Banhiran W, Assanasen P, Nopmaneejumruslers C, Metheetrairut C. Epworth sleepiness scale disordered breathing: the reliability and validity of the Thai version. Sleep Breath 2011;15: 571–7.
26.Banhiran W, Assanasen P, Metheetrairut C, Nopmaneejumruslers C, Chotinaiwattarakul W, Kerdnoppakhun J. Functional outcomes of sleep in thai patients with obstructive sleep-disordered breathing. Sleep Breath 2012;16:663–75.
27.Wolkove N, Baltzan M, Kamel H, Dabrusin R, Palayew M. Long-term compliance with continuous positive airway pressure in patients with obstructive sleep apnea. Can Respir J 2008;15: 365–9.
28.Sarrell EM, Chomsky O, Shechter D. Treatment compliance with continuous positive airway pressure device among adults with obstructive sleep apnea (OSA): how many adhere to treatment? Harefuah 2013;152:140–4.
29.Fischer Y, Gosepath J, Amedee RG, Mann WJ. Radiofrequency volumetric tissue reduction (RFVTR) of inferior turbinates: a new method in the treatment of chronic nasal obstruction. Am J Rhinol 2000;14:355–60.
30.Porter MW, Hales NW, Nease CJ, Krempl GA. Long-term results of inferior turbinate hypertrophy with radiofrequency treatment: a new standard of care? Laryngoscope 2006;116:554–7.
31.Saulescu M, Sarafoleanu C. Surgery for nasal obstruction in inferior turbinate hypertrophy. Romanian Journal of Rhinology 2015;5:25–30.
32.Garzaro M, Pezzoli M, Landolfo V, Defilippi S, Giordano C, Pecorari G. Radiofrequency inferior turbinate reduction: longterm olfactory and functional outcomes. Otolaryngol Head Neck Surg 2012;146:146–50.
33.Hirunwiwatkul P, Aeumjaturapata S, Oraphin P. Results of temperature-controlled radiofrequency tissue volume reduction for the turbinate hypertrophy. J Med Assoc Thai 2004; 87(Suppl 2):S91–4.
34.Nease CJ, Krempl GA. Radiofrequency treatment of turbinate hypertrophy: a randomized, blinded, placebo-controlled clinical trial. Otolaryngol Head Neck Surg 2004;130:291–9.
35.Cavaliere M, Mottola G, Lemma M. Comparison of the effectiveness and safety of radiofrequency turbinoplasty and traditional surgical technique in treatment of inferior turbinate hypertrophy. Otolaryngol Head Neck Surg 2005;133: 972–8.
36.Utley DS, Goode RL, Hakim I. Radiofrequency energy tissue ablation for the treatment of nasal obstruction secondary to turbinate hypertrophy. Laryngoscope 1999;109:683–6.
37.Shah AN, Brewster D, Mitzen K, Mullin D. Radiofrequency coblation versus intramural bipolar cautery for the treatment of inferior turbinate hypertrophy. Ann Oto Rhinol Laryngol 2015; 124:691–7.
38.Uluyol S, Karakaya NE, Gur MH, Kilicaslan S, Kantarcioglu EO, Yagiz O, et al. Radiofrequency thermal ablation versus bipolar electrocautery for the treatment of inferior turbinate hypertrophy: comparison of efficacy and postoperative morbidity. Int Arch Otolarhinolaryngol 2016;20:2–5.
39.Banhiran W, Tantilipikorn P, Metheetrairut C, Assanasen P, Bunnag C. Quality of life in patients with chronic rhinitis after radiofrequency inferior turbinate reduction. J Med Assoc Thai 2010;93:950–60.
40.Kilavuz AE, Songu M, Ozkul Y, Ozturkcan S, Katilmis H. Radiofrequency versus electrocautery for inferior turbinate hypertrophy. J Craniofac Surg 2014;26:1998–2001.
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2020-07-01
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Tawaranurak K, Sartyoungkul W, Wongkittihawon J. Radiofrequency Ablation Versus Bipolar Electrocautery for the Treatment of Nasal Obstruction in Obstructive Sleep Apnea Patients Using Continuous Positive Airway Pressure. J Health Sci Med Res [Internet]. 2020 Jul. 1 [cited 2024 Nov. 22];38(4):297-305. Available from: https://he01.tci-thaijo.org/index.php/jhsmr/article/view/244613
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