Tongue - Radiofrequency for Obstructive Sleep Apnea

Until now patients with obstructive sleep apnea have limited choices in treatments. CPAP is often difficult to tolerate. Many patients would like to avoid. Radiofrequency is a minimally invasive, outpatient procedure which reduces and tightens excess tissue in the upper airway responsible for Obstructive Sleep Apnea Syndrome, including the base of tongue, the most difficult to treat source of obstruction. The procedure usually takes place under local anesthesia and commonly as an outpatient, with the patient typically resuming normal activities the following day.

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The specially-designed handpiece creates limited zones of coagulation beneath the surface of the tissue. The surface tissue is shielded from thermal damage and is thereby unaffected. Over a period of three to eight weeks the treated tissue is resorbed, leading to volume reduction and improves airway obstruction. The procedure itself typically takes 30 to 45 minutes, with only 2 to 4 minutes of actual energy delivery. Typically more than one treatment is necessary to achieve optimal results.

Post-treatment sleep studies have demonstrated that TCRF effectively treat Obstructive Sleep Apnea Syndrome (OSAS).

Diagrams of TCRF

Submucosal Delivery of RF Energy
	The procedure takes place in an outpatient setting under local anesthesia. The physician inserts the surgical handpiece needle electrode into the base of the tongue. The radiofrequency generator delivers energy beneath the surface tissue while monitoring temperature.
Creation of Coagulative Lesion
	Tissue is heated in a limited area around the needle electrode, creating a coagulative lesion beneath the surface. Discomfort is minimal during the procedure and the surface tissue is protected from thermal damage. Over the course of one or more procedures, one or a number of lesions are created in the base of tongue.
Tissue Volume Reduction
	The lesions are naturally resorbed over a period of three to eight weeks, leading to reduction in tissue volume in the tongue helping to open the airway during sleep.

References: Radiofrequency Tongue Base

1. Powell N, Riley R, Guilleminault C, Troell R, Blumen M: Radiofrequency volumetric reduction of the tongue: a porcine pilot study for the treatment of obstructive sleep apnea syndrome. Chest 1997;111:1348-1355

2. Powell N, Riley R, Guilleminault C: Radiofrequency tongue base reduction in sleep disordered-breathing-a pilot study. Otolaryngol Head Neck Surg 1999;120:656-664

3. Riley RW, Powell NB, Li K, Weaver EM, Guilleminault C. An adjunctive method of radiofrequency volumetric tissue reduction of the tongue for OSAS. Otolaryngology Head and Neck Surgery, 129(1): 37-42. 2003

4. Kezirian E.J, Powell NB, Riley RW, Hester JE. Incidence of complications in radiofrequency treatment of the upper airway. Laryngoscope, 115 (7): 1298-304, 2005

5. Li KK, Powell NB, Riley RW, Guilleminault C. Temperate-controlled radiofrequency tongue base reduction for sleep-disordered breathing: Long term outcomes. Otolaryngology-Head and Neck Surgery 2002; 127:230-233

6. Troell R, Li K, Powell N, Riley R: Radiofrequency tongue base reduction in sleep-disordered breathing. Operative Techniques in Otolaryngology-Head Neck Surg 2000;11(1):47-49

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