Radiofrequency Ablation Treatment of Soft Palate for Patients with Snoring: A Systematic Review of Effectiveness and Adverse Effects

Objective: To assess the effectiveness and adverse effects of radiofrequency ablation (RFA) of soft palate (SP) in snoring. Study Design: Systematic search of electronic databases. Only articles published in peer-reviewed journals were evaluated. Included were controlled or prospective studies with at least 10 adults (>= 18 years of age) without moderate/severe obstructive sleep apnea. Results: Of the 159 articles identified, 30 met the inclusion criteria: two randomized controlled trials (RCT), four clinical controlled trials, and 24 prospective uncontrolled studies. The only placebo controlled RCT indicated SP RFA to be superior compared to placebo. The other RCT, comparing different radiofrequency ablation generators, showed no evidence of differences in snoring treatment efficacy, and only minor differences in patient discomfort. In two of the controlled trials snoring relief obtained by SP RFA was comparable, and in three of them associated with less postoperative pain than other interventions. Radiologic results were contradictory with some trials reporting significant changes of the upper airways, whereas others did not. Neither long-term side effects nor major adverse events have been reported after. Conclusions: The review provides evidence that SP RFA is an intervention causing less postoperative pain than others, and the risk of adverse effects for the patient seems to be small. It may reduce symptoms of snoring, at least in the short term. However, most of the published SP RFA literature is based on observational studies with a short follow-up time, which precludes solid conclusions about the effectiveness of the procedure.