Hypertonic saline injections to enhance the radiofrequency thermal ablation effect in the treatment of base of tongue in obstructive sleep apnoea patients: a pilot study.
CONCLUSIONS
Hypertonic saline (HS) infiltration in the base of the tongue (BOT) in multilevel radiofrequency ablation (RFA) treatment was followed by significant acute complications in terms of soft tissue swelling. Three patients were defined as cured. No significant changes in the measured parameters were encountered, although, several of them showed a clear trend. New treatment modalities are needed to keep multilevel RFA treatment as a minimally invasive procedure.


OBJECTIVE
To assess the efficacy and morbidity of RFA of the soft palate (SP) and BOT infiltrated with HS in obstructive sleep apnoea in a prospective, non-randomized clinical study.


METHODS
The inclusion criteria were age between 30 and 65 years, habitual snoring and excessive daytime sleepiness, a body mass index < or =33, and an apnoea-hypopnoea index > or =20. RFA of the SP and the BOT was delivered under local anaesthesia. HS solution was injected before the treatment into the BOT. The morbidity of the procedure was assessed with a visual analogue scale, and efficacy by separate questionnaires and sleep registration. The volume changes induced by the procedure were evaluated with cephalometric radiographs (CRs).


RESULTS
Twelve males and one female with a median age of 50 years (range 41-62) entered the study. Six patients (46%) had more postoperative swelling in the upper airway than expected. Three patients were defined as cured. The trend in the questionnaires was clear, but not significant. In the soft tissue airway CR measurements no significant changes were encountered, although a trend towards volume reduction was seen in the posterior airway space measure.
Bäck
Leif J J
LJ
Department of Otorhinolaryngology-Head and Neck Surgery, Helsinki University Central Hospital, Helsinki, Finland. leif.back@helsinki.fi
Liukko
Tommi
T
Rantanen
Irma
I
Peltola
Jaakko S
JS
Partinen
Markku
M
Ylikoski
Jukka
J
Mäkitie
Antti A
AA
D000328:Adult; D017115:Catheter Ablation; D004487:Edema / Q000209:etiology; D005260:Female; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D010160:Palate, Soft / Q000601:surgery; D019990:Perioperative Care; D010865:Pilot Projects; D011788:Quality of Life; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage*; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D012913:Snoring / Q000209:etiology / Q000628:therapy; D011795:Surveys and Questionnaires; D014059:Tongue / Q000601:surgery*; D016896:Treatment Outcome
D012462:Saline Solution, Hypertonic