Coblation Versus Radiofrequency for Tongue Base Reduction in Obstructive Sleep Apnea: A Meta-analysis.

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Abstract

The objective of this study is to determine the effectiveness and safety profile of coblation tongue base reduction (CBTR) compared to radiofrequency base of tongue (RFBOT) reduction on sleep-related outcomes in patients with obstructive sleep apnea (OSA).PubMed, Scopus, Web of Science, and Cochrane Database of Systematic Reviews databases.Literature search by 2 independent authors was conducted using the abovementioned databases. Studies on CBTR and RFBOT as part of OSA treatment in adult patients with pre- and postoperative apnea-hypopnea index (AHI) were included. Direct meta-analysis and single-arm meta-analysis were conducted to compare sleep-related outcomes (AHI, apnea index [AI], surgical success rates, Epworth sleepiness score [ESS], SpO2, body mass index [BMI], and visual analog scale [VAS]) between both groups.A total of 40 studies with a total of 1940 patients were included, of which 1440 individuals who underwent tongue base reduction interventions (RF?=?306, RF?+?UPPP?=?656, and coblation?+?UPPP?=?482) met inclusion criteria. Pooled analysis showed significant improvements in AHI (CBTR?=?-22.84, RFBOT?=?-11.14), AI (CBTR?=?15.64, RFBOT?=?-5.26), ESS (CBTR?=?-7.59, RFBOT?=?-7.18), mean oxygen saturation (CBTR?=?7.43, RFBOT?=?4.25), mean BMI (CBTR?=?-0.69, RFBOT?=?-4.09), and snoring visual analog scale (CBTR?=?-16.20, RFBOT?=?-18.21). Surgical success rate (postoperative AHI?50% from baselines) was 70% for CBTR and 43% for RFBOT.Both interventions decreased sleep-related outcomes in adult patients with OSA. Coblation appears to exhibit superiority over radiofrequency with a similar safety profile. However, further studies with direct comparisons between both interventions must be performed.

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