Tongue coblation via the ventral approach for obstructive sleep apnea-hypopnea syndrome surgery

作者：Hou Tiening; Hu Sunhong^*; Jiang Xiaohua

来源：Laryngoscope, 2012, 122(11): 2582-2586.

DOI：10.1002/lary.23556

• Obstructive sleep apnea syndrome
• radiofrequency
• ventral tongue
• lingual artery
• microinvasive tongue surgery
• Coblation
• Level of Evidence: 3b

Objectives/Hypothesis: To determine the safety and efficacy of tongue Coblation via the ventral approach in the treatment of hypopharyngeal obstruction for patients with obstructive sleep apneahypopnea syndrome (OSAHS). Study Design: Prospective casecontrol study. Methods: Tongue Coblation was performed under local anesthesia in one session in 40 inpatients diagnosed with OSAHS with predominant hypopharyngeal obstruction after failed uvulopalatopharyngoplasty. In the ventral approach (n = 20), only one puncture point was applied at the center of lingual frenulum, and 12 radiofrequency volumetric tissue reduction (RFVTR) lesions were implanted in the tongue. In the dorsal approach (n = 20), eight RFVTR lesions were distributed on the tongue. Using portable polysomnography (PSG) and the Epworth sleepiness questionnaire (ESQ), we followed 36 patients for 1 year after the operation. Good outcome was defined as apneahypopnea index <20 or reduction >50%. Results: In the ventral approach, total energy was accumulated to 23,000 J in 12 lesions, with postoperative pain 23 by visual analog scale (VAS). There was only one case of moderate venous bleeding and hematoma. The ESQ comparison indicated subjective improvements in patients, and PSG showed a curative effect in 11 of 19 (61.11%, eight of 19 success plus three of 19 responders), with a failure rate of eight of 19. By contrast, in the dorsal approach, total energy was 16,000 J, with postoperative pain 34 (VAS). Complications included mild to moderate tongue venous hematoma, severe infection of tongue, and temporary mild glossal deviation. A curative effect was seen in six of 17, with a failure rate of 11 of 17. Conclusions: Tongue Coblation via the ventral approach is an effective and safe technique to treat hypopharyngeal obstruction in OSAHS surgery. Laryngoscope, 2012

• 出版日期2012-11
• 单位浙江大学