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document
Preliminary findings from a prospective , randomized trial of two palatal operations for sleep-disordered breathing . OBJECTIVES We compared the efficacy of 2 palatal surgical procedures in the treatment of patients with mild sleep-disordered breathing ( SDB ) . STUDY DESIGN AND SETTING We conducted a prospective , randomized , crossover surgical trial at a university hospital . METHODS Twenty patients with mild SDB for whom conservative treatment failed were identified and consecutively enrolled into an institutional review board-approved surgical protocol . They were randomly assigned to undergo either radiofrequency ablation of the palate ( RFAP ) for a planned 3-stage treatment or laser-assisted uvulopalatoplasty ( LAUP ) , also for 3 stages of treatment , using a CO ( 2 ) laser . Parameters assessed included severity of SDB ( polysomnography ) , subjective and objective loudness of snoring ( visual analog scale and SNAP recording ) , sleepiness ( Epworth Sleepiness Scale ) , and anatomic changes ( upper airway endoscopy ) , as well as demographic factors . Patients not achieving satisfactory improvement in their condition were crossed over to the alternative surgical therapy for attempted salvage . RESULTS Seventeen of the enrolled patients have completed the protocol . Ten of these were randomized to the RFAP group , and 7 to the LAUP group . Six of the RFAP patients ( 60 % ) achieved a satisfactory resolution of their snoring , and 4 failed and were salvaged with LAUP . Six of the LAUP patients ( 86 % ) achieved a satisfactory resolution of their snoring , and 1 patient failed and was salvaged with nasal surgery . One patient who was initially cured had a relapse after 9 months and was successfully salvaged with RFA . CONCLUSION Prospective , randomized trials of surgery for SDB are possible . Preliminary findings from the current protocol reveal a slight advantage of LAUP over RFAP but with a greater degree of discomfort postoperatively .
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Intervention_Surgical
palatal operations
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Intervention_Surgical
2 palatal surgical procedures
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Intervention_Surgical
radiofrequency ablation of the palate ( RFAP ) for a planned 3-stage treatment
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Intervention_Surgical
laser-assisted uvulopalatoplasty ( LAUP ) , also for 3 stages of treatment , using a CO ( 2 ) laser
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Intervention_Physical
.
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Intervention_Surgical
alternative surgical therapy for attempted salvage
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Intervention_Physical
RFAP
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Intervention_Surgical
LAUP
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Intervention_Surgical
RFAP
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Intervention_Surgical
LAUP
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Intervention_Surgical
LAUP
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Intervention_Surgical
nasal surgery
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Intervention_Surgical
RFA
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Intervention_Surgical
LAUP
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Intervention_Surgical
RFAP
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Outcome_Other
efficacy
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Outcome_Physical
severity of SDB
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Outcome_Physical
subjective and objective loudness of snoring
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Outcome_Physical
sleepiness
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Outcome_Physical
anatomic changes
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Outcome_Physical
snoring
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Outcome_Physical
snoring
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Participant_Condition
patients with mild sleep-disordered breathing ( SDB )
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Participant_Sample-size
Twenty
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Participant_Condition
with mild SDB for whom conservative treatment failed