Snoring management with nasal surgery and upper airway radiofrequency ablation

Objective. To review techniques and outcomes of nasal surgery with upper airway radiofrequency ablation (RFA) when used for socially disruptive snoring, including the rate of infection with reused RFA applicator tips.Study Design. Case series with chart review.Setting. Community-based sleep-disordered breathing clinic.Methods. A prospectively acquired sleep quality assurance database was reviewed to determine demographics, complications, snoring outcomes, level of daytime sleepiness, and sleep-related quality of life in patients with socially disruptive snoring treated with nasal surgery and upper airway RFA.Results. One hundred thirty patients (48 women; 82 men) with a mean age of 50 years (range, 24-83 years) underwent nasal surgery and upper airway RFA for the treatment of chronic nasal blockage with socially disruptive snoring. All patients underwent septoplasty with or without inferior turbinate reduction and RFA to the soft palate and/or base of tongue. Patients received a mean of 2.2 (range, 1-4) applications of upper airway RFA during the course of treatment. No infections occurred with reuse of applicator tips. Fifty-four bed partners (42%) reported complete snoring resolution, whereas 68 (52%) reported residual snoring that was improved. Snoring resolution was more common in patients who underwent repeated applications of upper airway RFA (odds ratio 2.39; 95% confidence interval, 1.09-5.26).Conclusion. Nasal surgery combined with upper airway RFA improved snoring with few complications in this series of patients with anatomic nasal obstruction with socially disruptive snoring. Reuse of RFA applicator tips at palatal sites reduces cost without an observed increase in the risk of upper airway infection.