Stopping the obstruction behind the tongue continues to be an important part of treating sleep apnea surgically. Many techniques have been employed, from tissue excision or removal, suture slings to suspend the tongue from falling backwards during sleep as well as pending FDA approval techniques such as a nerve stimulator that will push the tongue out of the way at the appropriate time. However, most of these techniques require general anesthesia and some carry difficult postoperative recoveries.
The advent of radiofrequency (RF) energy has given way to a host of new surgical approaches for not only sleep apnea but many other specialties as well. It’s main advantage is in how this special energy is delivered, allowing much lower temperatures than traditional instrumentation which translates into more controlled release with less damage and pain for patients. This technique is often used for reducing the size of structures in the nose called turbinates. Turbinoplasty, or radiofrequency turbinate reduction, accomplishes shrinking of this tissue and improved nasal breathing with the technology. It can be performed in the operating room in conjunction with another procedure such as septoplasty or sinus surgery, but it can also be performed alone in the office under local anesthesia very successfully. I will sometimes offer this to patients who are seeking better nasal breathing, but it is unclear how much their deviated septum is contributing to this problem. By doing this first in the office, some may be spared having unnecessary septal surgery in the operating room.
Radiofrequency is also great for shrinking the base of tongue, which is often falling into the throat and causing an obstructive apnea for patients. It is accomplished with local anesthesia in the office with a special needle probe that delivers the advanced energy. While causing minimal pain, it does require multiple sessions to find significant clinical improvement. The risks, while rare, do include infection, abscess, bleeding and swelling, and should be taken seriously if there is any concern. If a patient is experiencing worsening pain after two to three days, they should immediately contact their doctor. I routinely use antibiotics and steroids post-procedure which reduce this risk dramatically. Patient experience mild discomfort after the procedure which reduces over a few days and is generally well tolerated.
This procedure is not for everyone, and like all sleep apnea procedures, results are never guaranteed. However, if you are interested in this procedure, a detailed evaluation of the head and neck by an Otolaryngologist specializing in Sleep Surgery will help determine your candidacy. Feel free to make an appointment if this minimally-invasive office procedure could be helpful for you.