Complication rates of radiofrequency surgery in the upper airways: a single institution experience.

CONCLUSION: Radiofrequency (RF) surgery of the upper airways appears to be a safe procedure with an acceptable incidence of minor and moderate complications. OBJECTIVES: RF surgery is increasingly used in the treatment of patients with sleep disordered breathing and inferior turbinate hypertrophy. Our aim was to investigate the incidence and the severity of the complications of RF surgery in the upper airways. PATIENTS AND METHODS: This was a retrospective, observational study at a tertiary care centre, academic teaching hospital during 1 year. Data from medical records were collected on 753 consecutive patients treated with RF surgery of the inferior turbinate, soft palate and base of the tongue. Patients with synchronous surgical treatment were excluded. RESULTS: In all, 413 patients (66.3% males) with a mean age of 44.7 years (range 8-83 years) were treated with 2926 RF surgery ablations in 524 treatment sessions. There were no severe complications. The overall incidence of minor and moderate complications was low, i.e. 2.7% (11/524) and 0.6% (3/524) of the treatment sessions, and 0.5% (11/2926) and 0.1% (3/2926) of the ablations, respectively.

Radiofrequency surgery of the soft palate in the treatment of mild obstructive sleep apnea is not effective as a single-stage procedure: A randomized single-blinded placebo-controlled trial.

OBJECTIVES/HYPOTHESIS: Radiofrequency (RF) surgery of the soft palate (SP) is an established treatment option for the treatment of snoring. Due to its minimally invasive character, it has received attention in the management of mild obstructive sleep apnea syndrome (OSAS). STUDY DESIGN: The aim of this study was to assess the efficacy and the occurrence of adverse events after single-stage SP RF surgery in patients with mild OSAS in a randomized single-blinded placebo-controlled trial in an outpatient department at a tertiary care center, academic teaching hospital. METHODS: Thirty-two patients with mild OSAS (apnea-hypopnea index [AHI] 5-15, body mass index <35) were randomized to receive a single session of RF surgery or placebo (insertion of applicator without energy delivery) with local anesthesia. The primary outcome measures were (AHI), Epworth Sleepiness Scale, and a 36-item short-form health survey quality-of-life questionnaire. The secondary measures were the soft tissue airway parameters in cephalometric radiographs, snoring scores, and rates of adverse events. RESULTS: Neither objectively measured significances (active AHI 11.0 [5.0-9.0] to 13.0 [2.0-26.0] and placebo AHI 12.0 [5.0-8.0] to 11.0 [1.0-29.0], P = .628), nor were trends of a diminishing effect on symptoms of mild OSAS found in the treatment arms. No significant changes in the soft tissue airway parameters occurred. One patient (5.9%) in the active treatment group was cured. CONCLUSIONS: RF surgery of SP is not recommended as a single-stage approach in mild OSAS.

Hypertonic saline injections to enhance the radiofrequency thermal ablation effect in the treatment of base of tongue in obstructive sleep apnoea patients: a pilot study.

CONCLUSION: Hypertonic saline (HS) infiltration in the base of the tongue (BOT) in multilevel radiofrequency ablation (RFA) treatment was followed by significant acute complications in terms of soft tissue swelling. Three patients were defined as cured. No significant changes in the measured parameters were encountered, although, several of them showed a clear trend. New treatment modalities are needed to keep multilevel RFA treatment as a minimally invasive procedure. OBJECTIVES: To assess the efficacy and morbidity of RFA of the soft palate (SP) and BOT infiltrated with HS in obstructive sleep apnoea in a prospective, non-randomized clinical study. PATIENTS AND METHODS: The inclusion criteria were age between 30 and 65 years, habitual snoring and excessive daytime sleepiness, a body mass index < or =33, and an apnoea-hypopnoea index > or =20. RFA of the SP and the BOT was delivered under local anaesthesia. HS solution was injected before the treatment into the BOT. The morbidity of the procedure was assessed with a visual analogue scale, and efficacy by separate questionnaires and sleep registration. The volume changes induced by the procedure were evaluated with cephalometric radiographs (CRs). RESULTS: Twelve males and one female with a median age of 50 years (range 41-62) entered the study. Six patients (46%) had more postoperative swelling in the upper airway than expected. Three patients were defined as cured. The trend in the questionnaires was clear, but not significant. In the soft tissue airway CR measurements no significant changes were encountered, although a trend towards volume reduction was seen in the posterior airway space measure.

Radiofrequency induced thermotherapy: an alternative palliative treatment modality in head and neck cancer.

Bipolar radiofrequency induced thermotherapy (RFITT) is a minimally invasive electrosurgical technique characterized by a precise controllable effect in the tissue. It has demonstrable efficacy, safety and reproducibility in the management of solid malignancies. Our aim was to assess the morbidity and efficacy of RFITT as a palliative treatment of head and neck cancer. Prospective, non-randomized case series and analysis. After evaluation by the multidisciplinary Head and Neck Tumour Board at Helsinki University Central Hospital, Finland, 12 consecutive patients with a head and neck cancer without curative treatment possibilities were enrolled into the study. Five patients had pharyngeal carcinomas, one had an unknown primary tumour growing through the skin on the neck, two had a recurrent malignant melanoma originating from the maxillary sinuses, one had a carcinoma of the tongue, two had laryngeal carcinomas, and one had a recurrent adenoid cystic carcinoma of the parotid gland. RFITT was performed with a CelonLabPrecision generator using appropriate electrodes. The treatment was administered under local or general anaesthesia. The subjective morbidity of the treatment was evaluated. The response to the treatment was assessed clinically and with radiological imaging when feasible. All but two of the patients received palliation to their disease. RFITT induced clinically a partial response in ten patients, and there were radiological detectable changes. There were no treatment related complications, and the patients tolerated the treatment well. RFITT in head and neck cancer patients is easy to perform, well tolerated, and induces reduction in the tumour mass. Continuous evaluation of RFITT treatment modality is warranted in selected palliative care patients.