Combined uvulopalatopharyngoplasty and radiofrequency tongue base reduction for treatment of obstructive sleep apnea/hypopnea syndrome

OBJECTIVE: In this study, we compare the objective results of uvulopalatopharyngoplasty (UPPP) combined with tongue base radiofrequency reduction (TBRF) with standard UPPP treatment of obstructive sleep apnea/hypopnea syndrome (OSAHS). STUDY DESIGN: We conducted a retrospective study of 277 patients who had stage I, II, or III OSAHS based on the Friedman staging system previously presented. METHODS: One hundred thirty-four patients who had treatment with UPPP only were used as a control group. This included 31 patients with stage I, 29 patients with stage II, and 74 patients with stage III OSAHS. An additional 143 patients with Stage II (n = 52) and III (n = 91) OSAHS were treated with combined UPPP and TBRF, initially and followed by additional TBRF treatments (up to 9000 J) as necessary. Subjective results were collected based on questionnaires and the Epworth Sleepiness Scale score for the experimental group, but these subjective measures were not available for the control group. Objective results were compared based on the polysomnographic findings before and after surgery. RESULTS: Subjectively, the study group did extremely well. Based on objective measures of successful treatment, UPPP plus TBRF resulted in a significantly higher percentage of patients who were "cured" of OSAHS compared with the control group. CONCLUSIONS: Stage I patients were usually successfully treated with UPPP only. However, patients allocated to stage II or III will benefit from the addition of TBRF to standard UPPP. Many UPPP-plus-TBRF patients in this study aborted further recommended TBRF treatments after subjective improvement and therefore objective results for this group, although improved in comparison to stage II and III patients treated with UPPP only, may not represent maximal potential improvement.