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Radiofrequency Volumetric Reduction of the Tongue : A Porcine Pilot Study for the Treatment of Obstructive Sleep Apnea Syndrome FREE TO VIEW

Nelson B. Powell; Robert W. Riley; Robert J. Troell; Marc B. Blumen; Christian Guilleminault
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From the Stanford University Sleep Disorders and Research Center, Stanford, Calif

1997 by the American College of Chest Physicians

Chest. 1997;111(5):1348-1355. doi:10.1378/chest.111.5.1348
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Study objective: To investigate, in an animal model, the feasibility of radiofrequency (RF) volumetric tongue reduction for the future purpose of determining its clinical applications in obstructive sleep apnea syndrome (OSAS).

Design: The study was performed in three stages, one in vitro bovine stage and two in vivo porcine stages. The last stage was a prospective investigation with histologic and volumetric analyses to establish outcomes.

Setting: Laboratory and operating room of veterinary research center.

Participants: A homogeneous population of porcine animal models, including seven in stage 2 and 12 in stage 3.

Intervention: RF energy was delivered by a custom-fabricated needle electrode and RF generator to the tongue tissue of both the in vitro and in vivo models.

Measurements and results: Microultrasonic crystals were used to measure three-dimensional changes (volumetric reduction). Lesion size correlated well with increasing RF energy delivery (Sperman correlation coefficient of 0.986; p=0.0003). Histologic assessments done serially over time (1 h through 3 weeks) showed a well-circumscribed lesion with a normal healing progression and no peripheral damage to nerves. Volumetric analysis documented a very mild initial edematous response that promptly tapered at 24 h. At 10 days after RF, a 26.3% volume reduction was documented at the treatment site (circumscribed by the microultrasonic crystals).

Conclusion: RF, in a porcine animal model, can safely reduce tongue volume in a precise and controlled manner. Further studies will validate the use of RF in the treatment of OSAS.




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