Radiofrequency tongue base reduction in sleep-disordered breathing: A pilot study.
OBJECTIVE
This pilot study investigates the new technology of radiofrequency energy (RFe), as applied to the tongue base, for the purpose of assessing feasibility, safety, and possible efficacy in the treatment of sleep-disordered breathing (SDB).


METHODS
Eighteen patients with SDB, in whom at least palatopharyngoplasty had failed, were entered in this study. The mean respiratory disturbance index was 39.6, with a mean nadir oxygen (SaO2) of 81.9%. A radiofrequency electrode delivered energy to the subsurface tongue base with local anesthetic. Polysomnography, quantitative speech and swallowing studies, questionnaires, and visual analog scales were used to assess outcomes. MRI assessed changes in tongue volume.


RESULTS
Separate RFe treatments (mean 5.5) at 4-week intervals were given (mean 1543 J for 9 minutes at 80 degrees C), for a mean energy total of 8490 J per patient. The posttreatment mean respiratory disturbance index was 17.8, and the SaO2 nadir was 88.3%. Weight increased slightly; speech and swallowing did not change. Questionnaires and visual analog scale scores showed improvement in study variables. Tongue volume was reduced by a mean of 17%. Pain was controlled by hydrocodone for 3 to 4 days. One infection was seen and resolved with incision and drainage.


CONCLUSIONS
This pilot study demonstrates feasibility, safety, and efficacy in reducing tongue volume using RFe. Additional cumulative energy may improve the cure rate for SDB.
Powell
N B
NB
Stanford University Sleep Disorders Center and the Stanford University Center of Excellence in Teaching and Clinical Care in Sleep Medicine, Stanford, California, USA.
Riley
R W
RW
Guilleminault
C
C
D000328:Adult; D001784:Blood Gas Analysis; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D010865:Pilot Projects; D017286:Polysomnography; D011446:Prospective Studies; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D011795:Surveys and Questionnaires; D014059:Tongue / Q000601:surgery*; D016896:Treatment Outcome
D010100:Oxygen