European Archives of Oto-Rhino-Laryngology

, Volume 271, Issue 6, pp 1809–1813 | Cite as

Multilevel radiofrequency ablation to the soft palate and tongue base: tips and pitfalls

Miscellaneous
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Abstract

The objective of the study is to increase awareness and understanding of the techniques and safety measures to minimise complications and improve patient outcomes. Literature review using MedLine and keywords snoring; obstructive sleep apnoea; radiofrequency ablation; electrosurgery; palate; tongue base was conducted. There is no accepted gold standard technique for radiofrequency ablation; to date, there is no published literature regarding common tips and pitfalls in radiofrequency application specifically for superficial applications and second-stage surgery. Surgery for snoring and obstructive sleep apnoea is typically multilevel. Pre-operative patient assessment and selection are critical to ensure good outcomes. Radiofrequency is generally safe and efficacious in this subset of patients. However, as with all surgery, it is operator-dependent. In particular, we emphasise the methodology for second-stage surgery, optimising visualisation and avoiding ulceration/fistulation of the soft palate, which are previously undescribed in the literature.

Keywords

Snoring Obstructive sleep apnoea Radiofrequency ablation Electrosurgery Palate Tongue base 
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Notes

Conflict of interest

None declared.

References

  1. 1.
    Stimpson P, Kotecha B (2011) Histopathological and ultrastructural effects of cutting radiofrequency energy on palatal soft tissues: a prospective study. Eur Arch Otorhinolaryngol 268:1829–1836PubMedCrossRefGoogle Scholar
  2. 2.
    Kotecha B (2012) Evaluation of the upper airway in patients with snoring and OSA, sleep disorders. In: Idzikowski C (Ed) Sleep Disorders, 1st Ed. InTech. Available from http://www.intechopen.com/books/sleep-disorders/evaluation-of-the-upper-airway-in-patients-with-snoring-and-osa
  3. 3.
    Georgalas C, Garas G, Hadjihannas E, Oostra A (2010) Assessment of obstruction level and selection of patients for obstructive sleep apnoea surgery: an evidence based approach. J Laryngol Otol 124:1–9PubMedCrossRefGoogle Scholar
  4. 4.
    Friedman M, Hamilton C, Samuelson CG, Lundgren ME, Pott T (2013) Diagnostic value of the Friedman tongue position and Mallampati classification for obstructive sleep apnea: a meta-analysis. Otolaryngol Head Neck Surg 148:540–547PubMedCrossRefGoogle Scholar
  5. 5.
    Hewitt RJD, Dasgupta A, Singh A, Dutta C, Kotecha B (2009) Is sleep nasendoscopy a valuable adjunct to clinical examination in the evaluation of upper airway obstruction? Eur Arch Otorhinolaryngol 266:691–697PubMedCrossRefGoogle Scholar
  6. 6.
    Abdullah VJ, Lee DL, Ha SC, Van Hasselt CA (2013) Sleep endoscopy with midazolam: sedation level evaluation with bispectral analysis. Otolaryngol Head Neck Surg 148:331–337PubMedCrossRefGoogle Scholar
  7. 7.
    Kezirian EJ, White DP, Malhotra A, Ma W, McCulloch CE, Goldberg AN (2010) Interrater reliability of drug-induced sleep endoscopy. Arch Otolaryngol Head Neck Surg 136:393–397PubMedCrossRefGoogle Scholar
  8. 8.
    Ravesloot MJ, de Vries N (2011) One hundred consecutive patients undergoing drug-induced sleep endoscopy: results and evaluation. Laryngoscope 121:270–276CrossRefGoogle Scholar
  9. 9.
    Stuck BA (2009) Radiofrequency-assisted uvulopalatoplasty for snoring: long-term follow-up. Laryngoscope 119:1617–1620PubMedCrossRefGoogle Scholar
  10. 10.
    Back LJ, Hytonen ML, Roine RP, Malmivaara AO (2009) Radiofrequency ablation treatment of soft palate for patients with snoring: a systematic review of effectiveness and adverse effects. Laryngoscope 119:1241–1250PubMedCrossRefGoogle Scholar
  11. 11.
    Baisch A, Maurer JT, Hormann K, Stuck BA (2009) Combined radiofrequency assisted uvulopalatoplasty in the treatment of snoring. Eur Arch Otorhinolaryngol 266:125–130PubMedCrossRefGoogle Scholar
  12. 12.
    NICE (2008) Continuous positive airway pressure for obstructive sleep apnoea/hypopnea syndrome. NICE. Available from http://www.nice.org.uk/nicemedia/pdf/ta139guidance.pdf
  13. 13.
    Friedman M, Ibrahim H, Joseph NJ (2004) Staging of obstructive sleep anpea/hypopnea syndrome: a guide to appropriate treatment. Laryngoscope 114:454–459PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Jagdeep Singh Virk
    • 1
  • Reza Nouraei
    • 1
  • Bhik Kotecha
    • 1
    • 2
  1. 1.ENT Department, Queen’s HospitalBarking, Havering and Redbridge University Hospitals NHS TrustEssexUK
  2. 2.ENT DepartmentRoyal Throat Nose and Ear HospitalLondonUK

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