Abstract
Objective: 1) To report on the evolution and success rate of radiofrequency volume reduction of the tongue base over a 12-year period. 2) Introduce a novel method for deploying the RFVR probes to the tongue base without pulling the tongue forward. 3) Show reduced complication rates by avoiding nerves and vessels. 4) Show increased success rate with increased number of lesions per treatment session. 5) Demonstrate the possibility of treating the genioglossus and geniohyoid muscles to shorten these muscles and retract the tongue anteriorly.
Method: In an IRB-approved prospective study at a community hospital, over 400 patients with obstructive sleep apnea over a 12 year period were selected for RFVR of the tongue base when there is evidence of hypopharyngeal involvement. Treatment evolved from single pronged to a double pronged probe with the rapid lesion mode and from to 2 lesions to 14 lesions. RFVR is usually performed in conjunction as part of multilevel treatment. Polysomnography prior to and 3 months after treatment were analyzed. Complications were recorded. Success is defined as RDI less than 20 and a greater than 50% reduction from preoperative levels.
Results: Success rates increased from 58% to 68% while the number of sessions of treatment decreased from 4 to 1 as the number of lesions increased from 2 to 14. There were no major complications.
Conclusion: RFVR of tongue base has evolved over a 12-year period to become a more efficacious and integral part of multilevel treatment for OSA.