Radio Frequency Ablation

The technique of tongue base radiofrequency ablation (RFA) has been performed for many years in the operating room, and has proven to be safe and effective. Only recently has this procedure been taken out of the operating room, and been performed in the office. The Tampa Sleep Apnea Center has worked with national leaders in sleep apnea surgery to develop a specific FDA approved protocol and technique that allows us to successfully and comfortably perform this procedure in the office. There is minimal discomfort during the procedure, which now takes less than 20 minutes and is performed using local anesthesia.

RFA Procedure Diagram

Delivering radio frequency energy
to tongue base

rfa1

Controlled lesion created
in tongue base

rfa2

Tissue volume reduction,
with enlarged airway

rfa3

What is the RFA procedure recovery like?

The procedure itself typically takes 2-5 minutes. There is usually 1-2 days of mild throat discomfort which is readily controlled with over-the-counter medications such as Tylenol or Aleve. Over a period of three to eight weeks the treated tissue is reabsorbed, leading to volume reduction and improves airway obstruction. There is no limitation in diet, activity or exercise. Patients usually return to work the next day, resume their regular diet, and may continue their usual exercise regimen.

Typically more than one treatment is necessary to achieve optimal results.

VIDEOS FROM AROUND THE WEB AND IN THE NEWS

Treating Sleep Apnea with the RFA Procedure

Other Treatment Options

The traditional treatment for OSA is the CPAP mask, which has to be used every night for the rest of your life.

This remains a good treatment option, and works for some people. However, MANY people are unable to sleep with the mask on their face and require a different treatment option.

Traditional surgeries include the classic uvulopalatopharyngoplasty (UPPP), which has been performed for decades, with some success.

This surgery is incredibly painful, requires a hospital stay, and has many possible complications. Other surgeries involve correction of specific sites of airway obstruction, such as the tonsils or a deviated septum. Dr. Anderson performs all of these surgeries, and bases his treatment recommendation on his thorough evaluation of your symptoms and findings on physical examination.

Although all types of treatment options are offered, we focus on the newer office-based sleep apnea treatment options, which can involve your nose and/or your throat. The most common source of snoring and OSA is the tongue base, and so our most popular procedure is the tongue base reduction using radiofrequency ablation (RFA).

This is a surprisingly simple and quick procedure that only requires local anesthesia, and takes a total of 15 minutes. It works by delivering a measured amount of energy into precise locations in the tongue base.

As these areas heal over the following days and weeks, the tissue tightens and shrinks, making for a more open and stable airway. This improves snoring and obstructive sleep apnea. There is very little down time from this procedure, and most patients take small doses of pain medication for one or two days.

Optimal treatment involves multiple procedures, staged one month apart to allow appropriate healing.

References: Radiofrequency Tongue Base

1. Powell N, Riley R, Guilleminault C, Troell R, Blumen M: Radiofrequency volumetric reduction of the tongue: a porcine pilot study for the treatment of obstructive sleep apnea syndrome. Chest 1997;111:1348-1355.
2. Powell N, Riley R, Guilleminault C: Radiofrequency tongue base reduction in sleep disordered-breathing-a pilot study. Otolaryngol Head Neck Surg 1999;120:656-664.
3. Riley RW, Powell NB, Li K, Weaver EM, Guilleminault C. An adjunctive method of radiofrequency volumetric tissue reduction of the tongue for OSAS. Otolaryngology Head and Neck Surgery 2003, 129(1): 37-42.
4. Kezirian E.J, Powell NB, Riley RW, Hester JE. Incidence of complications in radiofrequency treatment of the upper airway. Laryngoscope 2005, 115 (7): 1298-304.
5. Li KK, Powell NB, Riley RW, Guilleminault C. Temperate-controlled radiofrequency tongue base reduction for sleep-disordered breathing: Long term outcomes. Otolaryngology-Head and Neck Surgery 2002; 127:230-233.
6. Troell R, Li K, Powell N, Riley R: Radiofrequency tongue base reduction in sleep-disordered breathing. Operative Techniques in Otolaryngology-Head Neck Surg 2000;11(1):47-49.