Radiofrequency Volume Research Articles

A multi-institutional study of radiofrequency volumetric tissue reduction for OSAS

Objectives: Radiofrequency volume reduction (RFTVR) is a minor procedure directed at reducing the tongue base volume to treat obstructive sleep apnea. Subjective and objective treatment effectiveness was evaluated. Study Design and Setting: Two separate prospective, matched, nonrandomized, open enrollment treatment groups (RFTVR, n = 73 and nasal continuous positive airway pressure (CPAP, n = 99) were concurrently enrolled in a multicenter study. Results: Fifty-six (76.7%) RFTVR completed PSG with a mean 5.4 ± 1.8 treatments (13,394 ± 5459 joules). Perioperatively, acute pain was mild to moderate; edema, mucosal erosion, paresthesia, tinnitus were infrequent; and speech, swallowing taste, or throat irritation were unchanged. Self-reported outcomes did not differ between RFTVR and CPAP groups. Mean apnea/hypopnea index decreased (40.5 ± 21.5 to 32.8 ± 22.6 events/hr, P < 0.01). Electrolyte solution injected predicted results (r = 0.43, P < 0.001). The most severe complication was abscess (1.1%). Conclusion: RFTVR improves apnea/hypopnea index. Improvement may be related to solution injected with treatment. RFTVR and CPAP clinical outcomes improvement were similar. Clinical Significance: In mild obstructive sleep apnea, treatment of symptomatic outcomes with RFTVR may be an alternative to CPAP. (Otolaryngol Head Neck Surg 2001;125:303-11.)

Surgical approaches to obstructive sleep apnea.

Obstructive sleep apnea results from a combination of a structurally small upper airway and loss of upper airway muscle tone. Surgical therapy is effective by enlarging the upper airway and decreasing collapsibility. Limited palatal surgery has been demonstrated successful for the treatment of snoring but less for the treatment of obstructive sleep apnea. More aggressive multilevel surgeries addressing several airway segments demonstrate improved success rates. Multilevel surgeries and combined with bimaxillary advancement surgery have demonstrated success rates of 90%. New surgical procedures, eg, radiofrequency volume reduction, offer the potential of altering the upper airway with low morbidity. Hypoglossal nerve stimulation is a potential innovative technique.