title: The impact of pretreatment assessment of oropharynx on interstitial soft palate radiofrequency surgery outcome--a multi-center study in patients with habitual snoring.
abstract: OBJECTIVE
  Interstitial radiofrequency (RF) surgery of the soft palate (SP) is an established option in the treatment of habitual snoring. The decision-making process in the management of habitual snoring would benefit from diagnostic guidelines for oropharyngeal findings. Our aim was to investigate the correlation of systematic clinical pretreatment oropharyngeal examination scores with the efficacy of interstitial RF surgery of SP in a multi-center study.
  
  
  METHODS
  Seventy-four patients (58 (78%) males and 16 (22%) females) with the median age of 42 years (range, 23-64), pre-treatment BMI of 25.6 kg/m(2) (range, 20.0-28.0), and preoperative AHI of three events/h (range, 0-10), received a single session of RF surgery. Thirty-two, five, 16, and 21 patients, respectively, were treated at the participating centers with a follow-up time of 13 weeks (range 12-16). The primary outcome measure was the efficacy of the treatment on snoring assessed by the patient and the bed partner with visual analog scale (VAS).
  
  
  RESULTS
  The snoring showed a significant change demonstrating decreased snoring (VASpatpre 7 (range, 5-10) ≥VASpatpost 4.25 (range, 1-8), P < 0.001, VASbedppre 8 (range, 4-10) ≥VASbedppost 5 (range, 1-10), P < 0.001). Twenty-one patients (28.4%) experienced a successful treatment outcome. The increased grade of the uvula had a negative impact on the snoring results.
  
  
  CONCLUSIONS
  Systematic clinical pretreatment oropharyngeal examination scores showed that the increasing grade of the uvula correlated significantly with the short-term post-treatment change in snoring. We suggest that patients with habitual snoring and uvula grade III should be initially treated with SP interstitial RF surgery and concomitant uvular surgery. A grading tool is proposed for oropharyngeal examination to help in the most appropriate treatment decision for each individual snoring patient.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland. leif.back@helsinki.fi
authors.forename: Leif J J
authors.initials: LJ
authors.lastname: Bäck
authors.forename: Petri
authors.initials: P
authors.lastname: Koivunen
authors.forename: Ilmari
authors.initials: I
authors.lastname: Pyykkö
authors.forename: Brit K
authors.initials: BK
authors.lastname: Stene
authors.forename: Antti A
authors.initials: AA
authors.lastname: Mäkitie
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017115:Catheter Ablation; D005260:Female; D005500:Follow-Up Studies; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D009960:Oropharynx / Q000503:physiopathology*; D010160:Palate, Soft / Q000503:physiopathology* / Q000601:surgery*; D017286:Polysomnography; D011300:Preoperative Care; D011446:Prospective Studies; D012913:Snoring / Q000503:physiopathology* / Q000601:surgery*; D016896:Treatment Outcome; D014609:Uvula / Q000503:physiopathology / Q000601:surgery; D055815:Young Adult