Radiofrequency Tongue Base Reduction in Sleep-Disordered Breathing: A Pilot Study

Abstract

OBJECTIVE: This pilot study investigates the new technology of radiofrequency energy (RFe), as applied to the tongue base, for the purpose of assessing feasibility, safety, and possible efficacy in the treatment of sleep-disordered breathing (SDB). METHODS: Eighteen patients with SDB, in whom at least palatopharyngoplasty had failed, were entered in this study. The mean respiratory disturbance index was 39.6, with a mean nadir oxygen (SaO2) of 81.9%. A radiofrequency electrode delivered energy to the subsurface tongue base with local anesthetic. Polysomnography, quantitative speech and swallowing studies, questionnaires, and visual analog scales were used to assess outcomes. MRI assessed changes in tongue volume. RESULTS: Separate RFe treatments (mean 5.5) at 4-week intervals were given (mean 1543 J for 9 minutes at 80°C), for a mean energy total of 8490 J per patient. The posttreatment mean respiratory disturbance index was 17.8, and the SaO2 nadir was 88.3%. Weight increased slightly; speech and swallowing did not change. Questionnaires and visual analog scale scores showed improvement in study variables. Tongue volume was reduced by a mean of 17%. Pain was controlled by hydrocodone for 3 to 4 days. One infection was seen and resolved with incision and drainage. CONCLUSION: This pilot study demonstrates feasibility, safety, and efficacy in reducing tongue volume using RFe. Additional cumulative energy may improve the cure rate for SDB. The application of radiofrequency energy (RFe) for medical and surgical purposes has been extensively researched in the past. 1–4 We have recently applied these basic RFe principles to 3 consecutive investigations, which included 1 animal tongue model 5 and 2 human airway models (palate and turbinates). 6,7 These studies were done to specifically evaluate the biophysics and safety of RFe and to establish a scientific basis for the application of RFe to the human tongue in sleep-disordered breathing (SDB). The primary goal of this pilot investigation was to evaluate whether RFe could, in those with SDB and hypopharyngeal obstruction, reduce tongue volume and possibly improve SDB.