Hostname: page-component-848d4c4894-ttngx Total loading time: 0 Render date: 2024-05-14T12:56:51.228Z Has data issue: false hasContentIssue false

Incidence of complications after temperature-controlled radiofrequency treatment for sleep-disordered breathing: a Singapore sleep centre experience

Published online by Cambridge University Press:  11 July 2007

S-T Toh*
Affiliation:
Division of Otolaryngology, Changi General Hospital, Singapore
P-P Hsu
Affiliation:
Division of Otolaryngology, Changi General Hospital, Singapore
Y-H Ng
Affiliation:
Division of Otolaryngology, Changi General Hospital, Singapore
T-W D Teo
Affiliation:
Division of Otolaryngology, Changi General Hospital, Singapore
K-L A Tan
Affiliation:
Division of Otolaryngology, Changi General Hospital, Singapore
K-S P Lu
Affiliation:
Division of Otolaryngology, Changi General Hospital, Singapore
*
Address for correspondence: Dr Song-Tar Toh, Division of Otolaryngology, Changi General Hospital, 2 Simei Street 3, Singapore529889. Fax: 65 62609176 E-mail: songtar74@yahoo.com.sg

Abstract

Objective:

To determine the incidence of complications following temperature-controlled radiofrequency treatment of the soft palate, uvula and tongue base.

Study design:

Retrospective study.

Settings and methods:

We included all patients who had received temperature-controlled radiofrequency treatment of the soft palate, uvula and tongue base, for sleep-disordered breathing, over a four-year period in a tertiary hospital. Patients' medical records were systematically reviewed for radiofrequency treatment parameters and complications.

Main outcome measure:

Complication rates.

Results:

Seventy-six patients had been treated, with a total of 127 treatment sessions and 544 lesions to the palate, uvula and tongue base. The incidences of minor and moderate complications were, respectively, 2.6 per cent (14/544 lesions) and 0.4 per cent (2/544 treatment lesions), being 3.0 per cent (16/544 lesions) overall. Subdividing by anatomical region, the incidences of minor and moderate complications following palatal and uvula radiofrequency treatment were, respectively, 3.1 per cent (14/446 lesions) and 0 per cent, and those following tongue base treatment were, respectively, 0 per cent and 2.0 per cent (2/98 lesions). The incidence of minor complications following soft palate and uvula treatment, per treatment session, was 10.9 per cent. The incidence of moderate complications following tongue base treatment, per treatment session, was 4.6 per cent. There were no major complications in our study population.

Conclusions:

In this study, the incidence of complications of temperature-controlled radiofrequency treatment of the palate, uvula and tongue base was low. Temperature-controlled radiofrequency is a safe treatment modality for patients with sleep-disordered breathing and can be performed as a day case procedure. We recommend day admission for patients undergoing radiofrequency of the tongue base, in view of the potential for severe complications and airway compromise.

Type
Main Article
Copyright
Copyright © JLO (1984) Limited 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Young, T, Palta, M, Dempsey, J, Skatrud, J, Weber, S, Badr, S. The occurrence of sleep disordered breathing among middle-aged adults. N Engl J Med 1993;328:1230–5CrossRefGoogle ScholarPubMed
2 Ng, TP, Seow, A, Tan, WC. Prevalence of snoring and sleep breathing-related disorders in Chinese, Malay and Indian adults in Singapore. Eur Respir J 1998;12:198203CrossRefGoogle ScholarPubMed
3 Puvanendran, K, Goh, KL. From snoring to sleep apnea in a Singapore population. Sleep Res Online PMID: 11382877 1999;2:1114Google Scholar
4 Organ, LW. Electrophysiologic principles of radiofrequency lesion making. Appl Neurophysiol 1976;39:6976Google ScholarPubMed
5 Powell, NB, Riley, RW, Troell, RJ, Li, K, Blumen, MB, Guilleminault, C. Radiofrequency volumetric tissue reduction of the tongue. A porcine pilot study for the treatment of obstructive sleep apnea syndrome. Chest 1997;111:1348–55CrossRefGoogle Scholar
6 Powell, NB, Riley, RW, Troell, RJ, Li, K, Blumen, MB, Guilleminault, C. Radiofrequency volumetric tissue reduction of the palate in subjects with sleep-disordered breathing. Chest 1998;113:1163–74CrossRefGoogle ScholarPubMed
7 Powell, NB, Riley, RW, Guilleminault, C. Radiofrequency tongue base reduction in sleep-disordered breathing: a pilot study. Otolaryngol Head Neck Surg 1999;120:656–64Google Scholar
8 Li, KK, Powell, NB, Riley, RW, Troell, RJ, Guilleminault, C. Radiofrequency volumetric reduction of palate: an extended follow-up study. Otolaryngol Head Neck Surg 2000;122:410–14CrossRefGoogle ScholarPubMed
9 Utley, DS, Goode, RL, Hakim, L. Radiofrequency energy tissue ablation for the treatment of nasal obstruction secondary to turbinate hypertrophy. Laryngoscope 1999;109:683–6CrossRefGoogle ScholarPubMed
10 Fischer, Y, Gosepath, J, Amedee, R, Mann, JW. Radiofrequency volumetric tissue reduction (RFVTR) of inferior turbinates. Am J Rhinol 2000;6:16Google Scholar
11 Kerzirian, EJ, Powell, NB, Riley, RW, Hester, JE. Incidence of complications in radiofrequency treatment of the upper airway. Laryngoscope 2005;115:1298–304CrossRefGoogle Scholar
12 Stuck, BA, Starzak, K, Verse, T, Hormann, K, Maurer, JT. Complications of temperature-controlled radiofrequency volumetric tissue reduction for sleep-disordered breathing. Acta Otolaryngol 2003;123:532–5CrossRefGoogle ScholarPubMed
13 Terris, DJ, Chen, V. Occult mucosal injuries with radiofrequency ablation of the palate. Otolaryngol Head Neck Surg 2001;125:468–72CrossRefGoogle ScholarPubMed
14 Fischer, Y, Khan, M, Mann, WJ. Multilevel temperature-controlled radiofrequency therapy of soft palate, base of tongue, and tonsils in adults with obstructive sleep apnea. Laryngoscope 2003;113:1786–91Google Scholar
15 Emery, BE, Flexon, PB. Radiofrequency volumetric tissue reduction of the soft palate: a new treatment for snoring. Laryngoscope 2000;110:1092–8Google Scholar
16 Rombaux, P, Hamoir, M, Bertrand, B, Aubert, G, Liistro, G, Rodenstein, D. Postoperative pain and side effects after uvulopalatopharyngoplasty, laser-assisted uvulopalatoplasty, and radiofrequency tissue volume reduction in primary snoring. Laryngoscope 2003;113:2169–73CrossRefGoogle ScholarPubMed
17 Pazos, G, Mair, EA. Complications of radiofrequency ablation in the treatment of sleep-disordered breathing. Otolaryngol Head Neck Surg 2001;125:462–6Google ScholarPubMed
18 Stuck, BA, Kopke, J, Hormann, K, Verse, T, Eckert, A, Bran, G et al. Volumetric tissue reduction in radiofrequency surgery of the tongue base. Otolaryngol Head Neck Surg 2005;132:132–5CrossRefGoogle ScholarPubMed
19 Troell, RJ. Radiofrequency techniques in the treatment of sleep-disordered breathing. Otolaryngol Clin North Am 2003;36:473–93CrossRefGoogle ScholarPubMed
20 Stuck, BA, Maurer, JT, Hormann, K. Tongue base reduction with radiofrequency tissue ablation: preliminary results after two treatment sessions. Sleep Breathing 2000;4:155–62CrossRefGoogle ScholarPubMed