Combined bipolar radiofrequency surgery of the tongue base and uvulopalatopharyngoplasty for obstructive sleep apnea

Abstract

IntroductionThe aim of the study was to investigate the effectiveness of combined bipolar radiofrequency surgery of the tongue base (RFBT) and uvulopalatopharyngoplasty (UPPP) in a single session for obstructive sleep apnea and whether this combination is safe and well tolerated.Material and methodsSeventy-nine patients with obstructive sleep apnea and both palatal and retroglossal obstruction underwent UPPP with bipolar RFBT. The control group consisted of 35 patients treated by UPPP alone.ResultsThe apnea-hypopnea index significantly decreased from 28.7 to 14.1. The oxygen desaturation index decreased from 15.1 to 10.3. Mean oxygen saturation was unchanged. Subjectively, the Epworth Sleepiness Scale was significantly improved from 10.6 to 7.3, and the snoring level decreased from 8.4 to 6.0. The overall treatment success rate increased from 41.9% for UPPP alone to 51.7% for UPPP + RFBT. No serious adverse events occurred. Two patients had postoperative bleeding from the tonsillar bed after UPPP. Four patients had ulceration of the base of the tongue after RFBT with spontaneous cure. One patient had a taste change in half of the tongue that resolved within two months.ConclusionsCombined bipolar RFBT and UPPP in a single session is well tolerated and safe surgery in the treatment of obstructive sleep apnea. It is effective in reducing respiratory parameters and subjective symptoms of obstructive sleep apnea. Further advantages are a single session, simple feasibility, bipolar technique and short time of the procedure.

Influence of Radiofrequency Surgery on Architecture of the Palatine Tonsils

“…Although volume reduction impact has been generally proposed, it is not the result of treatment in each tissue. Relevant changes after radiofrequency surgery of the base of the tongue for obstructive sleep apnea could be observed neither for tongue volume or dimension nor for retrolingual space [ 6 , 7 ]. The effects of radiofrequency surgery of the tongue base may more likely be a result of changes in upper airway collapsibility after scarring, postnecrotic fibrosis.…”

Obstructive sleep apnoea and the need for its introduction into dental curricula

“…Mild‐to‐moderate patients with OSA who are CPAP resistant may be appropriate for surgical interventions such as uvuloplasty, bipolar radiofrequency surgery of the tongue base and correction of nasal pathologies . Complicated upper airway surgeries such as bimaxillary orthognathic procedures , anterior inferior mandibular sagittal osteotomy, genioplasty, maxillomandibular advancement osteotomies and uvulopalatopharyngoplasty are less frequently offered due to lower than 50% significant improvement in AHI in some patients and potentially serious post‐operative complications . The indications and efficacy of surgical treatment of OSA for patients who fail to respond to CPAP therapy are yet to be determined .…”