Low-Temperature Bipolar Radiofrequency Ablation (Coblation) of the Tongue Base for Supine-Position-Associated Obstructive Sleep Apnea

Abstract

Objective: To assess the effectiveness of low-temperature bipolar radiofrequency ablation for Coblation of the tongue base in the multilevel management of supine-position-associated obstructive sleep apnea syndrome (OSAS). Study Design and Setting: A retrospective analysis of the data of 16 subjects undergoing uvulopalatopharyngoplasty and tongue base Coblation. The efficacy of the procedure was investigated on the basis of polysomnographic results. Results: The success rate was 62.5% in 16 patients who underwent surgery for OSAS, with decreases in the mean Apnea Hypopnea Index of 20.1–8.9. The success rate was separately evaluated according to the subjects’ posture. A rate of 87.5% was found for the supine position, while the rate was 56.6% in non-supine positions. The minimum postoperative O₂ saturation was significantly increased for REM and non-REM stage 3 sleep rates. Conclusion: It is important to evaluate the relation of the disease to the body position in sleep apnea subjects. Coblation of the tongue base is an applicable method of therapy for patients who have sleep apnea that is more marked in the supine position.

Comparison of robotic and coblation tongue base resection for obstructive sleep apnoea

“…A coblator can be used in two‐handed surgery to provide visualisation with the assistance of an endoscope in a holding system, as we previously reported . When using a coblator, the tongue base can be exposed with a Jennings mouth gag without a tongue blade, and bilateral traction sutures . This procedure is very effective, but we encountered difficulties in tongue base exposure and reapplied the mouth gag with the tongue blade.…”

“…Recently, tongue base obstruction has been recognised as one of the essential anatomic regions that may be challenging to surgeons due to difficult access and limited surgical techniques. With the development of new surgical equipment, tongue‐directed methods such as coblation tongue base surgery and transoral robotic surgery (TORS) have become popular therapeutic options for downsizing tongue volume . Previously, we reported the feasibility and predictors of surgical outcomes in coblation or robotic tongue base resection with lateral pharyngoplasty as part of a multilevel treatment strategy for OSA .…”

Comparison of Minimally Invasive Techniques in Tongue Base Surgery in Patients with Obstructive Sleep Apnea

“…[14][15][16][17] Retroglossal airway obstructions are related to supine-dependent OSA, and the volume of the tongue base should also be reduced in addition to a soft palate surgical procedure for an effective treatment. 19,27 Genioglossus advancement, hyoepiglottoplasty, hyoid or thyrohyoid suspension, and tongue base suspension sutures with different surgical approaches have been subjected to much research in multilevel surgery of OSA. 8,13 The potential complications of hyoid and thyrohyoid suspensions include prolonged odynophagia, speech impairments, dysphagia, hematoma, infection, and pain.…”

Our experiences with tongue base radiofrequency, for treatment of obstructive sleep apnea

“…Özellikle pozisyona bağlı TUAS da dil kökü radyofrekans uygulamasının başarılı olduğu vurgulanmaktadır. 10 Yapılan çalışmalarda radyofrekans cerrahisinin dil kökü hipertrofisinin tedavisinde etkin ve kolay uygulanabilir bir yöntem olduğunu destekler niteliktedir. 6 Civelek Ş ve ark.…”