Local-anaesthesia, one-step sleep surgery

INTRODUCTION: This report presents a single-institution prospective case series evaluating the feasibility and effect of outpatient local anaesthesia radiofrequency ablation-assisted soft palate volumetric tissue reduction (RFA-SP) and turbinoplasty (RFA-T) for treatment of patients with obstructive sleep apnoea (OSA) and/or snoring. METHODS: A total of 72 patients with Apnea-Hypopnoea Index (AHI) > 5 and/or subjective snoring treated in 2024 were evaluated after surgery, including cardiorespiratory monitoring (CRM) and patient questionnaire evaluation. Main endpoints were AHI, Snore Index (SI), Epworth Sleepiness Scale and scored impact of sleep-disordered breathing on quality of life. RESULTS: We conclude that the procedures have low morbidity and high patient satisfaction. Approximately one in two patients had improved symptoms. However, improvement in AHI and SI was mainly seen in total or non-supine positions. The main limitations of our study are: the placebo effect in patient self-evaluations, the relatively small study population, the availability of comprehensive and recent pre- and post-surgery CRMs and the underlying premise that the mechanisms of sleep-disordered breathing remain poorly understood. CONCLUSIONS: Outpatient RFA-SP and RFA-T under local anaesthesia effectively improve symptoms and quality of life in patients with OSA and snoring, producing complete resolution in selected cases. The best outcomes are seen in non-supine OSA, highlighting the need for careful preoperative assessment to optimise patient selection. FUNDING: None. TRIAL REGISTRATION: The study protocol was approved by the Aarhus University Hospital Management. The Central Denmark Region Committees on Health Research Ethics were consulted and found the project non-notifiable.