Tongue Base Procedures

Tongue base procedures can involve removal of lingual tonsils, radiofrequency reduction of the tongue base, and the SMILE procedure (Submucosal Minimally Invasive Lingual Excision).  Yes, you do have tonsils in your tongue.  They are very small in most people but can be large contributing to airway obstruction.  Lingual tonsillectomy is performed under general anaesthetic.  There are various tools that can be used to remove the tonsils including coblation, a microdebrider, or electrocautery.  Radiofrequency reduction of the tongue base uses coblation (in my practice) to reduce the bulky tissue.  The coblation needle is placed into the base of tongue in several locations causing scaring and tissue shrinkage.  This brings the tongue foreward which widens the airway.  The first procedure is usually done under general anaethetic at the same time as other airway procedures.  It often has to be repeated 2 to 3 months after the initial procedure.  The procedure itself typically takes 30 to 45 minutes, with only 2 to 4 minutes of actual energy delivery.  The repeat procedure usually takes place under local anesthesia.  Typically you can resume normal activities the following day. Coblation creates small areas of scarring in the base of the tongue.  These are naturally resorbed over a period of three to eight weeks, leading to reduction in tissue volume in the tongue helping to open the airway during sleep. The SMILE procedure is a new variant.  It still uses coblation technology but a different tip which removes more tissue.  Discomfort and complications seem to be higher with this procedure (see research section) but results are improved.