Multilevel temperature‐controlled radiofrequency therapy of soft palate, base of tongue, and tonsils in adults with obstructive sleep apnea

Abstract

Moderate to severe obstructive sleep apnea usually requires multilevel pharyngeal surgery. Radiofrequency offers the potential of altering the upper airway on different sites.

The Efficacy of Multilevel Surgery of the Upper Airway in Adults With Obstructive Sleep Apnea/Hypopnea Syndrome

“…None of their patients had concomitant nasal surgery. Fischer et al 32 presented a similar study about multilevel minimally invasive surgery with RF on the palate, tonsil, and tongue base for 15 OSAHS patients. Stuck et al 36 published their surgical results with RF on the palate and base of the tongue for 18 OSAHS patients with mild/moderate disease.…”

Non-CPAP therapies in obstructive sleep apnoea

“…No changes of swallowing or speech were observed [232,263,267,271]. The addition of radiofrequency surgery to other surgical approaches, such as UPPP, nasal surgery, tonsillar surgery, palatal implants or hyoid suspension, did not lead to an increase in morbidity [270,[272][273][274][275][276][277].…”

First-Choice Treatment in Mild to Moderate Obstructive Sleep Apnea

“…9 Fischer et al 3 reported a similar study of 16 patients undergoing radiofrequency reduction of the palate and tongue base with a success rate of only 33%. 3 Whereas all of the patients in the study by Fischer et al 3 had moderate disease, those in the study by Steward 9 had mild to moderate disease. Although many surgeons include nasal surgery with UPPP, this is the second study to include a combined 3-level treatment with minimally invasive techniques, at the level of the soft palate and the base of the tongue, in addition to nasal surgery.…”

“…Surgical therapy is effective because it enlarges the upper airway and decreases collapsibility. 3,16 Surgical success has been defined as an AHI of 20 or less and a 50% or greater reduction in the AHI. Both criteria must be present for the outcome to be defined as successful.…”

“…3 Therefore, the concept of 2-level pharyngeal collapse should be replaced by a dynamic "multilevel collapse concept," reflecting the complex pattern of collapsibility of the entire pharyngeal tube during sleep. 3 To improve the surgical cure rates for OSA, the entire upper airway must be brought under inspection, and each level of obstruction identified needs to be addressed. The treatment plan should potentially include nasal, oropharyngeal and palatal, and hypopharyngeal measures to improve the airway.…”