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

Abstract

Objective: 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).

Data sources: PubMed, Scopus, Web of Science, and Cochrane Database of Systematic Reviews databases.

Review methods: 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.

Results: 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 < 20 and drop >50% from baselines) was 70% for CBTR and 43% for RFBOT.

Conclusion: 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.