Skip to main content
SpringerLink
Log in

Histopathological and ultrastructural effects of cutting radiofrequency energy on palatal soft tissues: a prospective study

  • Miscellaneous
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Radiofrequency (RF) surgery has gained popularity as a safe and effective method for treating patients with snoring and mild obstructive sleep apnoea (OSA). Both interstitial and cutting radiofrequency energy may be used for multi-segmental management of the upper airway. Little is known about the effect of cutting radiofrequency energy on human soft palate. Excessive collateral injury may have an impact on tissue healing and functional outcomes. A histological analysis of specimens of human soft palate and uvula following resection with cutting RF energy was performed. In addition, ultrastructural analysis using scanning electron microscopy of excision margins was performed and compared with CO2 LASER. Twelve patients were included. In ten patients, specimens of redundant uvula and faucial pillars were collected and underwent formal histological analysis. The maximum depth of tissue injury was 1 mm in two specimens and overall average depth of injury was 0.15 mm. Injury depth was independent of tissue subtype at the resection margin. Ultrastructural analysis demonstrated accurate incision when compared to CO2 LASER. Cutting RF energy causes minimal collateral injury to the soft palate during resection for the treatment of snoring and mild OSA. A detailed knowledge of local effects on resection specimens allows accurate inference of in vivo tissue injury at the resection margin and may enable more precise prediction of healing patterns and repair.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  1. Nelson LM (2000) Radiofrequency treatment for obstructive tonsillar hypertrophy. Arch Otolaryngol Head Neck Surg 126:736–740

    PubMed  CAS  Google Scholar 

  2. Friedman M, LoSavio P, Ibrahim H et al (2003) Radiofrequency tonsil reduction: safety, morbidity, and efficacy. Laryngoscope 113:882–887

    Article  PubMed  Google Scholar 

  3. Nelson LM (2003) Temperature-controlled radiofrequency tonsil reduction in children. Arch Otolaryngol Head Neck Surg 129:533–537

    Article  PubMed  Google Scholar 

  4. Ragab SM (2005) Bipolar radiofrequency dissection tonsillectomy: a prospective randomized trial. Otolaryngol Head Neck Surg 133:961–965

    Article  PubMed  Google Scholar 

  5. Ragab SM (2005) The effect of radiofrequency and mitomycin C on the closure rate of human tympanostomy. Otol Neurotol 26:355–360

    Article  PubMed  Google Scholar 

  6. Li KK, Powell NB, Riley RW, Troell RJ et al (1998) Radiofrequency volumetric tissue reduction for treatment of turbinate hypertrophy: a pilot study. Otolaryngol Head Neck Surg 119:569–573

    Article  PubMed  CAS  Google Scholar 

  7. Utley DS, Goode RL, Hakim I (1999) Radiofrequency energy tissue ablation for the treatment of nasal obstruction secondary to turbinate hypertrophy. Laryngoscope 109:683–686

    Article  PubMed  CAS  Google Scholar 

  8. Hierl T, Mueller G, Meister E et al (2000) Radiofrequency therapy (RFT) for turbinate hypertrophy. In: 4th European Congress of Oto-Rhino-Laryngology Head and Neck Surgery, vols 1 and 2, pp 1157–1160

  9. Coste A, Yona L, Blumen M et al (2001) Radiofrequency is a safe and effective treatment of turbinate hypertrophy. Laryngoscope 111:894–899

    Article  PubMed  CAS  Google Scholar 

  10. Seeger J, Zenev E, Gundlach P et al (2003) Bipolar radiofrequency-induced thermotherapy of turbinate hypertrophy: pilot study and 20 months follow-up. Laryngoscope 113:130–135

    Article  PubMed  Google Scholar 

  11. Hytonen ML, Back LJJ, Malmivaara AV et al (2009) Radiofrequency thermal ablation for patients with nasal symptoms: a systematic review of effectiveness and complications. Eur Arch Otorhinolaryngol 266:1257–1266

    Article  PubMed  Google Scholar 

  12. O’Connor-Reina C, Garcia-Iriarte MT, Angel DG et al (2007) Radiofrequency volumetric tissue reduction for treatment of turbinate hypertrophy in children. Int J Pediatr Otorhinolaryngol 71:597–601

    Article  PubMed  Google Scholar 

  13. Powell NB, Riley RW, Troell RJ et al (1998) Radiofrequency volumetric tissue reduction of the palate in subjects with sleep-disordered breathing. Chest 113:1163–1174

    Article  PubMed  CAS  Google Scholar 

  14. Emery BE, Flexon PB (2000) Radiofrequency volumetric tissue reduction of the soft palate: a new treatment for snoring. Laryngoscope 110:1092–1098

    Article  PubMed  CAS  Google Scholar 

  15. Taliaferro C (2001) Submucosal radiosurgical uvulopalatoplasty for the treatment of snoring: is the monitoring of tissue impedance and temperature necessary? Otolaryngol Head Neck Surg 124:46–50

    Article  PubMed  CAS  Google Scholar 

  16. Sher AE, Flexon PB, Hillman D et al (2001) Temperature-controlled radiofrequency tissue volume reduction in the human soft palate. Otolaryngol Head Neck Surg 125:312–318

    Article  PubMed  CAS  Google Scholar 

  17. Farrar J, Ryan J, Oliver E et al (2008) Radiofrequency ablation for the treatment of obstructive sleep apnea: a meta-analysis. Laryngoscope 118:1878–1883

    Article  PubMed  Google Scholar 

  18. Tatla T, Sandhu G, Croft CB et al (2003) Celon (R) radiofrequency thermo-ablative palatoplasty for snoring—a pilot study. J Laryngol Otol 117:801–806

    PubMed  CAS  Google Scholar 

  19. Baisch A, Maurer JT, Hormann K et al (2009) Combined radiofrequency assisted uvulopalatoplasty in the treatment of snoring. Eur Arch Otorhinolaryngol 266:125–130

    Article  PubMed  Google Scholar 

  20. Patel N, Gill J, Kotecha B (2006) How I do it—the Kotecha technique for laser palatoplasty. Eur Arch Otorhinolaryngol 263:152–155

    Article  PubMed  Google Scholar 

  21. Powell NB, Riley RW, Troell RJ et al (1997) Radiofrequency volumetric reduction of the tongue—a porcine pilot study for the treatment of obstructive sleep apnea syndrome. Chest 111:1348–1355

    Article  PubMed  CAS  Google Scholar 

  22. Ge NN, Schalch P, Senders CW (2009) The macroscopic and microscopic effects of radiofrequency injury in the porcine tongue: a pilot study. Otolaryngol Head Neck Surg 141:408–412

    Article  PubMed  Google Scholar 

  23. Fomin D, Nicola E, Oliver C et al (2007) Collagen type analysis in the soft palate after surgical intervention with CO2 laser and radiofrequency ablation. Photomed Laser Surg 25:449–454

    Article  PubMed  Google Scholar 

  24. Courey MS, Fomin D, Smith T et al (1999) Histologic and physiologic effects of electrocautery, CO2 laser, and radiofrequency injury in the porcine soft palate. Laryngoscope 109:1316–1319

    Article  PubMed  CAS  Google Scholar 

  25. Poyrazoglu E, Dogru S, Saat B et al (2006) Histologic effects of injection snoreplasty and radiofrequency in the rat soft palate. Otolaryngol Head Neck Surg 135:561–564

    Article  PubMed  Google Scholar 

  26. Bassiouny A, Nasr S, Mashaly M et al (2009) Electron microscopy study of peripheral nerves in the uvulae of snorers and obstructive sleep apnoea patients. J Laryngol Otol 123:203–207

    Article  PubMed  CAS  Google Scholar 

  27. Sargon M, Celik H, Uslu S et al (2009) Histopathological examination of the effects of radiofrequency treatment on mucosa in patients with inferior nasal concha hypertrophy. Eur Arch Otorhinolaryngol 266:231–235

    Article  PubMed  Google Scholar 

  28. Smith TL, Smith JM (2001) Electrosurgery in otolaryngology-head and neck surgery: principles, advances, and complications. Laryngoscope 111:769–780

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

Dr. Dhafir Al-Okati: Consultant Histopathologist, Queens Hospital, Romford, UK. Mr. Graham Thwaites: Lead HistopathologyTechnician, Queens Hospital, Romford, UK. Professor Andrew Forge: Centre for Auditory Research, UCL Ear institute, London, UK.

Conflicts of interest

None declared.

Author information

Authors and Affiliations

  1. Royal National Throat, Nose and Ear Hospital, 330 Gray’s Inn Road, London, WC1X 8DA, UK

    Paul Stimpson & Bhik Kotecha

  2. Queens Hospital, Romford, UK

    Paul Stimpson & Bhik Kotecha

Authors
  1. Paul Stimpson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bhik Kotecha
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Paul Stimpson.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Stimpson, P., Kotecha, B. Histopathological and ultrastructural effects of cutting radiofrequency energy on palatal soft tissues: a prospective study. Eur Arch Otorhinolaryngol 268, 1829–1836 (2011). https://doi.org/10.1007/s00405-011-1634-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-011-1634-7

Keywords

Search

Navigation