Combined bipolar radiofrequency surgery of the tongue base and uvulopalatopharyngoplasty for obstructive sleep apnea.
BACKGROUND
The aim of the study was to investigate the effectiveness of combined bipolar radiofrequency surgery of the tongue base (RFBT) and uvulopalatopharyngoplasty (UPPP) in a single session for obstructive sleep apnea and whether this combination is safe and well tolerated.


METHODS
Seventy-nine patients with obstructive sleep apnea and both palatal and retroglossal obstruction underwent UPPP with bipolar RFBT. The control group consisted of 35 patients treated by UPPP alone.


RESULTS
The apnea-hypopnea index significantly decreased from 28.7 to 14.1. The oxygen desaturation index decreased from 15.1 to 10.3. Mean oxygen saturation was unchanged. Subjectively, the Epworth Sleepiness Scale was significantly improved from 10.6 to 7.3, and the snoring level decreased from 8.4 to 6.0. The overall treatment success rate increased from 41.9% for UPPP alone to 51.7% for UPPP + RFBT. No serious adverse events occurred. Two patients had postoperative bleeding from the tonsillar bed after UPPP. Four patients had ulceration of the base of the tongue after RFBT with spontaneous cure. One patient had a taste change in half of the tongue that resolved within two months.


CONCLUSIONS
Combined bipolar RFBT and UPPP in a single session is well tolerated and safe surgery in the treatment of obstructive sleep apnea. It is effective in reducing respiratory parameters and subjective symptoms of obstructive sleep apnea. Further advantages are a single session, simple feasibility, bipolar technique and short time of the procedure.
Department of Otorhinolaryngology and Head and Neck Surgery, 1 Faculty of Medicine, Charles University, Faculty Hospital Motol, Prague, Czech Republic ; Institute of Anatomy, 1 Faculty of Medicine, Charles University, Prague, Czech Republic.
Jan
J
Plzak
Department of Otorhinolaryngology and Head and Neck Surgery, 1 Faculty of Medicine, Charles University, Faculty Hospital Motol, Prague, Czech Republic.
Michal
M
Zabrodsky
Department of Otorhinolaryngology and Head and Neck Surgery, 1 Faculty of Medicine, Charles University, Faculty Hospital Motol, Prague, Czech Republic.
Jan
J
Kastner
Department of Otorhinolaryngology and Head and Neck Surgery, 1 Faculty of Medicine, Charles University, Faculty Hospital Motol, Prague, Czech Republic.
Jaroslav
J
Betka
Department of Otorhinolaryngology and Head and Neck Surgery, 1 Faculty of Medicine, Charles University, Faculty Hospital Motol, Prague, Czech Republic.
Jan
J
Klozar
obstructive sleep apnea; radiofrequency; uvulopalatopharyngoplasty