Boris Pételle

Traitement du syndrome d’apnées obstructives du sommeil de l’adulte par orthèse d’avancée mandibulaire : actualisation des connaissances

Resume Le syndrome d’apnees obstructives du sommeil constitue un risque de sante non negligeable qui merite une prise en charge de la part des specialistes des voies aeriennes superieures. Lorsque le diagnostic de SAHOS est fonde, il convient de le traiter et differents moyens sont repertories. Differents traitements sont envisages : ventilation par pression positive (VPPC), ortheses d’avancee mandibulaire (OAM), interventions chirurgicales (tissus mous et tissus durs). Les auteurs developpent particulierement les traitements par OAM en decrivant leurs repercussions positives et negatives sur la ventilation, sur les ATM, les bases osseuses et les relations interarcades.

Radiofrequency Soft Palate Procedure in Snoring: Influence of Energy Delivered:

OBJECTIVE: We conducted a retrospective study to evaluate the influence of amount of energy delivered during radiofrequency procedure for soft palate reduction in snoring, to improve the cure rate. METHODS: Consecutive patients with chronic disruptive snoring presenting to our department were successively treated in an outpatient procedure. A visual analog scale was used to assess the severity of snoring by the bed partner and the pain by the patient, before treatment and after each treatment session. The soft palate was divided into 3 treatment sites: middle, lateral right, and lateral left. Any mucosal injury of the soft palate was classified as a complication. RESULTS: Forty-3 patients were classified into 2 groups according to energy assignment. The total amount of energy delivered was 1250 J in group 1 (n = 15) and 1500 J in group 2 (n = 28). Energy was predominantly distributed in the middle of the soft palate in group 1 (550 J) and group 2 (800 J). After each treatment session, the 1500-J delivery of radiofrequency energy (total per session) led to a better snoring grading reduction in comparison with the 1250-J delivery with a significant difference after 2 treatment sessions (P < 0.05). The mean pain score and the incidence rate of complications per treatment were not statistically different in comparing both groups. CONCLUSION: Better snoring scores can be expected by increasing radiofrequency energy applied to the soft palate. Further randomized long-term investigations are required to confirm that the cure rate can be improved when increasing energy with a suitable distribution and good clinical tolerance.