Er:YAG laser for snoring: a systemic review and meta-analysis

A new outpatient non-surgical method using Er:YAG laser for snoring has been demonstrated. The aim of this systematic review and meta-analysis was to investigate the effects of this treatment on snoring. Relevant 1548 articles were searched from various databases from 1 January 2000 to September 2018 including PubMed, MEDLINE, EMBASE, Cochrane Library, Web of Science, and Scopus and reference lists. Meta-analysis was performed with RevMan software. Cochran's Q and I-2 statistics were used to assess heterogeneity. The overall effect was evaluated using z-tests. Seven studies and two hundred forty-seven participants treated with two to three sessions of Er:YAG 2940 nm laser (long pulse mode, 10 Hz, fluence 1.6 J/cm(2)) were included. There was a statistically significant reduction of pooled snoring VAS (mean difference (MD) (95% CI), - 6.89 (- 7.62, - 6.15)). Patient satisfaction rate after laser treatment was 80% (95% CI, 70.69, 89.05) of cases. A widening of the upper airway dimension was revealed; however, changes in apnea-hypopnea index (AHI) and respiratory disturbance index (RDI) were not significantly different. Mean follow-up period was 3 to 36 months. Patients tolerated the procedure well without anesthesia. There were minimal side effects without serious adverse effects. Er:YAG laser is shown to be effective in a way to reduce snoring without significant AHI or RDI changes. However, randomized controlled trials, objective data, multicenter cooperation, and long-term outcomes are needed to confirm the benefits of this laser for snoring.