The Effect of the Tongue Base and Soft Palate Radiofrequency with the Maximized Therapeutic Dose in Obstructive Sleep Apnea in Patients Undergoing Uvulopalatopharyngoplasty Re-surgery

Document Type : Original Article (s)

Authors

1 Associate Professor, Department of Ear, Nose, and Throat, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Student of Medicine, Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran

3 Oral and Maxillofacial Medicine Specialist, Dental Research Center AND Department of Oral and Maxillofacial Medicine, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran

4 Community Medicine Specialist, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Diseases, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Obstructive sleep apnea is a chronic disease that requires long-term treatment. One of these treatments is a surgery called uvulopalatopharyngoplasty (UPPP). According to various theories about the use of radiofrequency in UPPP surgery, the purpose of this study was to investigate the effect of maximum dose of radiofrequency on the base of the tongue and soft palate in treatment of obstructive sleep apnea in patients undergoing UPPP re-surgery.Methods: In this clinical trial study, 40 patients with obstructive sleep apnea were divided into two equal groups. The first group underwent UPPP surgery with radiofrequency of the base of tongue and soft palate with maximal dose, and the second group or control group underwent UPPP surgery. Then, the data were compared between the two groups.Findings: There was no significant difference between the two groups regarding visual analog scale (VAS), Epworth sleepiness scale (ESS) and apnea-hypopnea index (AHI) before the operation (P > 0.05 for all). After the surgery, the mean VAS snoring and ESS in the intervention group was significantly lower than the control group (P < 0.05 for both).Conclusion: The use of radiofrequency of the soft palate and base of the tongue in association with UPPP effectively leads to a significant improvement in snoring, reduces the amount of drowsiness during the day, and plays an important role in improving the quality of life in patients undergoing UPPP re-surgery.

Keywords

References

  1. Epstein LJ, Kristo D, Strollo PJ, Jr., Friedman N, Malhotra A, Patil SP, et al. Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med 2009; 5(3): 263-76.
  2. Capdevila OS, Kheirandish-Gozal L, Dayyat E, Gozal D. Pediatric obstructive sleep apnea: complications, management, and long-term outcomes. Proc Am Thorac Soc 2008; 5(2): 274-82.
  3. Young T, Peppard PE, Gottlieb DJ. Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med 2002; 165(9): 1217-39.
  4. Fokkens W, Lund V, Mullol J. European position paper on rhinosinusitis and nasal polyps 2007. Rhinol Suppl 2007; 20: 1-136.
  5. Eun YG, Shin SY, Kim SW. Effects of uvulopalatopharyngoplasty with or without radiofrequency tongue base reduction on voice in patients with obstructive sleep apnea. Laryngoscope 2013; 123(7): 1806-10.
  6. Plzak J, Zabrodsky M, Kastner J, Betka J, Klozar J. Combined bipolar radiofrequency surgery of the tongue base and uvulopalatopharyngoplasty for obstructive sleep apnea. Arch Med Sci 2013; 9(6): 1097-101.
  7. Zhang XM, Tham CJ, Yin YL, Sun YQ, Zhou X. A novel palatal implant surgery combined with uvulopalatopharyngoplasty and inferior turbinate radiofrequency for the treatment of moderate to severe obstructive sleep apnea: a pilot study. Eur Arch Otorhinolaryngol 2015; 272(5): 1195-202.
  8. Friedman M, Ibrahim H, Joseph NJ. Staging of obstructive sleep apnea/hypopnea syndrome: a guide to appropriate treatment. Laryngoscope 2004; 114(3): 454-9.
  9. Janssen KC, Phillipson S, O'Connor J, Johns MW. Validation of the Epworth Sleepiness Scale for Children and Adolescents using Rasch analysis. Sleep Med 2017; 33: 30-5.
  10. Fujita S, Conway W, Zorick F, Roth T. Surgical correction of anatomic azbnormalities in obstructive sleep apnea syndrome: uvulopalatopharyngoplasty. Otolaryngol Head Neck Surg 1981; 89(6): 923-34.
  11. Thaler ER, Rassekh CH, Lee JM, Weinstein GS, O'Malley BW, Jr. Outcomes for multilevel surgery for sleep apnea: Obstructive sleep apnea, transoral robotic surgery, and uvulopalatopharyngoplasty. Laryngoscope 2016; 126(1): 266-9.
  12. Caples SM, Rowley JA, Prinsell JR, Pallanch JF, Elamin MB, Katz SG, et al. Surgical modifications of the upper airway for obstructive sleep apnea in adults: a systematic review and meta-analysis. Sleep 2010; 33(10): 1396-407.
  13. Verse T, Wenzel S, Brus J. Multi-level surgery for obstructive sleep apnea. Lingual tonsillectomy vs. hyoid suspension in combination with radiofrequency of the tongue base. Sleep Breath 2015; 19(4): 1361-6.
  14. Vicini C, Montevecchi F, Pang K, Bahgat A, Dallan I, Frassineti S, et al. Combined transoral robotic tongue base surgery and palate surgery in obstructive sleep apnea-hypopnea syndrome: expansion sphincter pharyngoplasty versus uvulopalatopharyngoplasty. Head Neck 2014; 36(1): 77-83.
  15. Powell NB, Riley RW, Troell RJ, Li K, Blumen MB, Guilleminault C. Radiofrequency volumetric tissue reduction of the palate in subjects with sleep-disordered breathing. Chest 1998; 113(5): 1163-74.
  16. Amali A, Motiee-Langroudi M, Saedi B, Rahavi-Ezabadi S, Karimian A, Amirzargar B. A comparison of uvulopalatopharyngoplasty and modified radiofrequency tissue ablation in mild to moderate obstructive sleep apnea: A randomized clinical trial. J Clin Sleep Med 2017; 13(9): 1089-96.
  17. Blumen MB, Dahan S, Fleury B, Hausser-Hauw C, Chabolle F. Radiofrequency ablation for the treatment of mild to moderate obstructive sleep apnea. Laryngoscope 2002; 112(11): 2086-92.
  18. Stuck BA, Kopke J, Hormann K, Verse T, Eckert A, Bran G, et al. Volumetric tissue reduction in radiofrequency surgery of the tongue base. Otolaryngol Head Neck Surg 2005; 132(1): 132-5.
Journal of Isfahan Medical School
Volume 36, Issue 500 - Serial Number 500
September and October 2017
Pages 1242-1247

Files

History

  • Receive Date: 28 June 2018
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics