title: Temperature-controlled radiofrequency tongue base reduction for sleep-disordered breathing: Long-term outcomes.
abstract: OBJECTIVE
  Our goal was to evaluate the long-term outcomes of temperature-controlled radiofrequency reduction of the tongue base in sleep-disordered breathing.
  
  
  METHODS
  The 18 patients from our initial pilot study were reevaluated. Clinical examinations, polysomnography (PSG), questionnaires, visual analog scales, and a comparative SF-36 were used to assess long-term outcomes.
  
  
  RESULTS
  Sixteen of the original 18 patients completed this study; 2 patients were lost to follow-up. The mean follow-up was 28 months. There was a mean weight increase of 3.1 +/- 7.9 kg. The original pretreatment Respiratory Disturbance Index (RDI) was a mean of 39.5 with a mean mean oxygen saturation nadir (LSAT) of 81.9%, and the posttreatment RDI was a mean of 17.8 with a mean LSAT of 88.3%. Follow-up PSG data showed a persistent improvement of the mean Apnea Index compared with pretreatment (5.4 vs 22.1) without significant changes compared with posttreatment (4.1). However, there were changes in the follow-up Hypopnea Index (HI) of 22.9 compared with the pretreatment and posttreatment HI values of 17.4 and 13.6, respectively. This resulted in a relapse of the RDI from a posttreatment value of 17.8 to 28.7. The LSAT also worsened from 88.3% to 85.8%. However, there was no significant deterioration in the quality-of-life measurements by SF-36 or in daytime sleepiness by Epworth Sleepiness Scale.
  
  
  CONCLUSIONS
  The success of temperature-controlled radiofrequency tongue base reduction for sleep-disordered breathing may reduce with time. PSG demonstrated that long-term relapse is primarily reflected in the HI without significant detrimental effects on the patient's quality of life (SF-36) and sleepiness (Epworth Sleepiness Scale). Continual evaluation of this treatment modality is warranted.
authors.affiliation: Stanford University Sleep Disorders and Research Center, California, USA. kaseyli@hotmail.com
authors.forename: Kasey K
authors.initials: KK
authors.lastname: Li
authors.forename: Nelson B
authors.initials: NB
authors.lastname: Powell
authors.forename: Robert W
authors.initials: RW
authors.lastname: Riley
authors.forename: Christian
authors.initials: C
authors.lastname: Guilleminault
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D017115:Catheter Ablation / Q000379:methods*; D003679:Deglutition; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D011788:Quality of Life; D012008:Recurrence; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D013060:Speech; D011795:Surveys and Questionnaires; D013997:Time Factors; D014059:Tongue / Q000601:surgery*; D016896:Treatment Outcome