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Bulldogs are the only other mammal to snore. They are a type of brachycephalic dog meaning they have been bred to have a short head. Their palate and uvula is often too long for their mouth and they may have to have it trimmed surgically to stop them from strangling in their sleep.
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Home Published Articles Tongue Base Reduction Radiofrequency tongue base reduction in sleep-disordered breathing: A pilot study
Radiofrequency tongue base reduction in sleep-disordered breathing: A pilot study Print E-mail

Powel Nelson B et al. Otolaryngology Head and Neck Surgery;120(5):656-664

 

My Take:

This is a pilot study so it is limited by the low numbers.  It is able to show a low rate of complications and an impressive clinical result with almost all patients showing significant improvement.  One patient (5%) had a slight worsening of sleep apnea. 

Although attempts to control sleep apnea can be performed with palatal procedures, many patients will require a tongue base procedure to achieve good control.  This procedure is much easier, has a very rapid recovery, and has a lower complications than maxillary-mandibular advancement or other base of tongue procedures.  

 

Summary:

This is the original study to look at using a temperature controlled radiofrequency device to reduce the volume of the tongue base.  The tongue base is involved in sleep apnea and snoring in at least 75% of patients.  Techniques in the past have had fairly high complications and prolonged post-operative recovery.  

 

Eighteen patients with moderate to severe sleep apnea who failed palatal procedures to control sleep apnea were enrolled in the study.  The treatments were performed under local anaesthetic with 2 sites treated per visit.  Visits were scheduled 4 to 6 weeks apart.  There was an average of 5 to 6 treatment sessions per patient.  

 

Results:

The average reduction in tongue size was 17.4 cm3 using MRI scans.  Using cephalometricts (x-rays) the posterior airway space (the size of the airway behind the tongue) improved an average of 54%.  The AHI improved from an average of 39 before treatment to an average of 17 after treatment.  In one patient there was a slight worsening of sleep apnea.  In all other patients there was a significant improvement. 

 

Complications:

Three complications were recorded in total (considering all patients and all sessions).  One patient had an ulcer in the tongue after treatment which healed quickly on its own.  

One patient had pain with swallowing starting 5 days after his second treatment.  This resolved on its own within 3 days. 

One patient had a tongue infection 3 weeks after his second treatment.  This required a temporary tracheostomy and incision and drainage in the operating room followed by systemic antibiotics.  There was a rapid recovery.