title: Comparative effects of snoring sound between two minimally invasive surgeries in the treatment of snoring: a randomized controlled trial.
abstract: BACKGROUND
  Minimally invasive surgeries of the soft palate have emerged as a less-invasive treatment for habitual snoring. To date, there is only limited information available comparing the effects of snoring sound between different minimally invasive surgeries in the treatment of habitual snoring.
  
  
  OBJECTIVE
  To compare the efficacy of palatal implant and radiofrequency surgery, in the reduction of snoring through subjective evaluation of snoring and objective snoring sound analysis.
  
  
  METHODS
  Thirty patients with habitual snoring due to palatal obstruction (apnea-hypopnea index ≤15, body max index ≤30) were prospectively enrolled and randomized to undergo a single session of palatal implant or temperature-controlled radiofrequency surgery of the soft palate under local anesthesia. Snoring was primarily evaluated by the patient with a 10 cm visual analogue scale (VAS) at baseline and at a 3-month follow-up visit and the change in VAS was the primary outcome. Moreover, life qualities, measured by snore outcomes survey, and full-night snoring sounds, analyzed by a sound analytic program (Snore Map), were also investigated at the same time.
  
  
  RESULTS
  Twenty-eight patients completed the study; 14 received palatal implant surgery and 14 underwent radiofrequency surgery. The VAS and snore outcomes survey scores were significantly improved in both groups. However, the good response (postoperative VAS ≤3 or postoperative VAS ≤5 plus snore outcomes survey score ≥60) rate of the palatal implant group was significantly higher than that of the radiofrequency group (79% vs. 29%, P = 0.021). The maximal loudness of low-frequency (40-300 Hz) snores was reduced significantly in the palatal implant group. In addition, the snoring index was significantly reduced in the radiofrequency group.
  
  
  CONCLUSIONS
  Both palatal implants and a single-stage radiofrequency surgery improve subjective snoring outcomes, but palatal implants have a greater effect on most measures of subjective and objective snoring. Multi-stage radiofrequency surgery was not tested.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT01955083.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital at Linkou, School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan, R.O.C.; Sleep Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan, R.O.C.; Department of Otolaryngology, Xiamen Chang Gung Hospital, Xiamen, Fujian Province, China.
authors.forename: Li-Ang
authors.initials: LA
authors.lastname: Lee
authors.affiliation: Graduate Institute of Medical Mechatronics, Taiouan Interdisciplinary Otolaryngology Laboratory, Chang Gung University, Taoyuan, Taiwan, R.O.C.
authors.forename: Jen-Fang
authors.initials: JF
authors.lastname: Yu
authors.affiliation: Sleep Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan, R.O.C.; Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital at Linkou, School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan, R.O.C.
authors.forename: Yu-Lun
authors.initials: YL
authors.lastname: Lo
authors.affiliation: Sleep Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan, R.O.C.; Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital at Linkou, School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan, R.O.C.
authors.forename: Ning-Hung
authors.initials: NH
authors.lastname: Chen
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital at Linkou, School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan, R.O.C.; Sleep Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan, R.O.C.
authors.forename: Tuan-Jen
authors.initials: TJ
authors.lastname: Fang
authors.affiliation: Department of Laboratory Medicine, Chang Gung Memorial Hospital at Linkou, College of Medicine, Chang Gung University, Taoyuan, Taiwan, R.O.C.
authors.forename: Chung-Guei
authors.initials: CG
authors.lastname: Huang
authors.affiliation: Graduate School of Recreation and Sports Management, Taipei Physical Education College, Taipei, Taiwan, R.O.C.
authors.forename: Wen-Nuan
authors.initials: WN
authors.lastname: Cheng
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital at Linkou, School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan, R.O.C.; Sleep Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan, R.O.C.
authors.forename: Hsueh-Yu
authors.initials: HY
authors.lastname: Li
mesh_terms: D015992:Body Mass Index; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D010160:Palate, Soft / Q000601:surgery*; D012913:Snoring / Q000473:pathology / Q000601:surgery*; D013018:Sound Spectrography; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D016896:Treatment Outcome