Postoperative pain and side effects after uvulopalatopharyngoplasty, laser-assisted uvulopalatoplasty, and radiofrequency tissue volume reduction in primary snoring.
OBJECTIVE
We compared, in a prospective study, the side effects and the postoperative complications of three procedures commonly used for the treatment of primary snoring.


METHODS
Forty-nine patients underwent velopharyngeal surgery for primary snoring (17 for uvulopalatopharyngoplasty [UPPP]; 15 for laser-assisted uvulopalatoplasty [LAUP], and 17 for radiofrequency tissue volume reduction [RFTVR]). Preoperative full polysomnographic studies ruled out obstructive sleep apnea syndrome. Each patient's evaluation encompassed postoperative pharyngeal pain (as measured by a 5-point visual analogue scale) and use of narcotic drugs in the early postoperative period as well as a subjective evaluation of late postoperative complaints. A surgeon's examination was performed to report postoperative complications in the oropharynx.


RESULTS
Postoperative pharyngeal pain was less important in the RFTVR group than in the UPPP and LAUP groups. Mean scores at days 3, 7, 16 were as follows: 4.2, 4.0, and 2.4, respectively, for UPPP; 4.6, 3.8, and 1.6 for LAUP; and 2.4, 2.0, and 0.7 for RFTVR. Mean duration of pain with a score greater than 2 was calculated as follows: UPPP, 21.3 days; LAUP, 15.1 days; and RFTVR, 6.1 days. Mean duration of narcotic drug use for the patients who needed this medication was 10.1 days for UPPP, 7.2 days for LAUP, and 1.3 for RFTVR. Postoperative side effects (trouble with smell and taste, pharyngeal dryness, globus sensation, voice change, and pharyngonasal reflux) were more present in the UPPP and LAUP groups than in the RFTVR group. Surgeon's assessment for postoperative complications reported more wound infection, dehiscence, and posterior pillar narrowing in the UPPP and LAUP groups than in the RFTVR group.


CONCLUSIONS
RFTVR is a safer and less painful procedure than UPPP and LAUP for the treatment of primary snoring. Postoperative discomfort after LAUP and after UPPP appears to be very similar.
Rombaux
Philippe
P
Department of Otorhinolaryngology, Université Catholique de Louvain, Cliniques Universitaires Saint Luc, Hippocrate Avenue 10, 1200 Brussels, Belgium. philippe.rombaux@orlo.ucl.ac.be
Hamoir
Marc
M
Bertrand
Bernard
B
Aubert
Genevieve
G
Liistro
Giuseppe
G
Rodenstein
Daniel
D
D000328:Adult; D004598:Electrosurgery / Q000379:methods; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D009960:Oropharynx; D010149:Postoperative Pain; D010159:Palate / Q000601:surgery*; D010608:Pharyngeal Diseases / Q000209:etiology; D010614:Pharynx / Q000601:surgery*; D011183:Postoperative Complications; D011446:Prospective Studies; D012913:Snoring / Q000601:surgery*; D016896:Treatment Outcome; D014609:Uvula / Q000601:surgery*