Lionel M. Nelson

High energy single session radiofrequency tongue treatment in obstructive sleep apnea surgery.

Objective To evaluate the safety and outcomes of a high-energy single session treatment as an alternative to a cumulative energy multiple staged approach when using temperature-controlled radiofrequency tissue ablation (TCRFTA) for tongue base obstruction in sleep apnea surgery. STUDY DESIGN AND METHODS Retrospective study of 176 consecutive Fujita II (tongue and palate level obstruction) patients undergoing single session palate, tonsil, and nasal surgery, and concurrent tongue base TCRFTA by the application of 10,500 J of energy. RESULTS Median follow-up was 156.5 days. There were no serious complications. There were five (2.8%) superficial tongue ulcers, and three (1.7%) persistent taste disturbances after treatment; 174 patients were on sustainable oral intake and adequate oral pain control within 24 hours of surgery; 98 had comparable post operative sleep studies. Apnea-hypopnea indexes decreased from 35.3 ± 23.9 to 22.6 ± 21.5 (P < 0.0001). Epworth Sleepiness Scale scores improved from 11.2 ± 4.9 to 5.9 ± 4.6 (P < 0.000001). CONCLUSION High energy single session tongue base TCRFTA is a safe procedure with low morbidity.

Magnetic Airway Implants for the Treatment of Obstructive Sleep Apnea Syndrome

OBJECTIVE: To evaluate repelling magnetic implants to treat obstructive sleep apnea (OSA) using a canine model. STUDY DESIGN AND SETTING: Magnetic forces equivalent to effective CPAP were estimated with benchtop studies. An acute canine model was used to simulate pharyngeal collapse. Tolerance, safety, and stability of the implants were evaluated in a chronic series of 10 dogs observed over 6 months. RESULTS: Equivalence to CPAP (10-12 cm H20) was achieved with low-force (<10 g/cm length), light (approximately 2 gram) implants. Magnetic implants prevented airway collapse in the acute canine. Normal behavior, swallowing, and oral intake were noted in the chronic canine over 6 months. Implant extrusion was 10%. Histology showed fibrous encapsulation without chronic inflammation. CONCLUSIONS: Repelling magnets successfully maintained a patent airway and were well tolerated in the canine. SIGNIFICANCE: Repelling magnets could represent an implantable alternative to CPAP if human studies reveal similar findings.

09:48: High-Energy Radiofrequency Tongue Ablation in OSA Surgery

30mo; 95%CI) compared to neck (avg. 14.4 months, 7.520.7mo; 95%CI) and other tumor sites, (avg. 18 months, 13.822.3mo; 95%CI). Further analysis of neck treatments showed that tumors away from the common carotid in cervical lymph nodes located in levels I, IV, and V had median survival of 25.9 months (mean 37.7mo), compared to 11.4 months (mean 10.9mo) in patients with tumors near, or encroaching the carotid in upper and lower jugular levels II and III. In conclusion, patients tolerated LITT well on an outpatient basis, and were successfully palliated for periods ranging from 39 days to 90 months post-treatment. CONCLUSIONS: Based on the findings of this study it was possible to show that proximity to the carotid artery was the most relevant factor in projecting patient survival.