Primary Outcome Measures:
- Number of days to cessation of narcotic pain medication use during the 21-day post-treatment period.
Secondary Outcome Measures:
- Number of days to pain resolution as measured using a visual analogue scale during the 21-day post-treatment period.
- Analysis of timing of self-administration of medication during the 21-day post-treatment period
- Analysis of daily pain intensity using a visual analogue scale during the 21-day post-treatment period.
Sleep apnea is a condition characterized by repeated episodes of paused or stopped breathing during sleep. Obstructive sleep apnea (OSA) occurs when respiratory effort is made but is unsuccessful due to upper airway obstruction or collapse. Most subjects presenting with OSA can be identified as having pathology that originates in the area of the soft palate and uvula. OSA is estimated to affect up to 4% of adults and is a potentially serious medical condition associated with cardiovascular disease, neuropsychiatric problems related to excessive daytime sleepiness and increased morbidity and mortality.
In some instances, OSA can be treated with conservative measures such as behavior modification including weight loss, sleep positioning, and avoidance of certain drugs. Continuous positive airway pressure (CPAP) is an alternative non-surgical treatment however, low long-term patient compliance rates limit its therapeutic use. Surgical procedures to enlarge or bypass the upper airway obstruction or collapse include tonsillectomy and uvulopalatopharyngoplasty (UPPP). Tonsillectomy and UPPP using monopolar electrocautery are effective, however, both are associated with severe post-operative discomfort and the heat generated by this modality can cause increased tissue damage and slower healing, potentially resulting in significant limitations in activity and diet. Recently, limited treatment of soft palatal tissues using Coblation under local anesthesia has shown promise as an alternate technique to relieve snoring in mild obstructive sleep apnea. At present however, postoperative recovery from pain with this technique has not been compared to conventional surgical methods using a controlled study design in an adult population.
This prospective clinical study is designed to assess whether tonsillectomy and UPPP performed using a COBLATION device to treat OSA symptoms in an adult population is associated with less postoperative pain during the 21-day postoperative recovery period compared to electrocautery dissection. The amount of post-operative pain will be assessed daily over the 21-day post-operative recovery period using two general measures: 1) self-reported pain intensity and 2) self-reported pain medication administration, including frequency of use and dose. Further, timing of self-medication will be analyzed separately.
Purpose
