Hypertonic saline injections to enhance the radiofrequency thermal ablation effect in the treatment of base of tongue in obstructive sleep apnoea patients: a pilot study

Abstract

Conclusion. Hypertonic saline (HS) infiltration in the base of the tongue (BOT) in multilevel radiofrequency ablation (RFA) treatment was followed by significant acute complications in terms of soft tissue swelling. Three patients were defined as cured. No significant changes in the measured parameters were encountered, although, several of them showed a clear trend. New treatment modalities are needed to keep multilevel RFA treatment as a minimally invasive procedure. Objectives. To assess the efficacy and morbidity of RFA of the soft palate (SP) and BOT infiltrated with HS in obstructive sleep apnoea in a prospective, non-randomized clinical study. Patients and methods. The inclusion criteria were age between 30 and 65 years, habitual snoring and excessive daytime sleepiness, a body mass index ≤33, and an apnoea-hypopnoea index ≥20. RFA of the SP and the BOT was delivered under local anaesthesia. HS solution was injected before the treatment into the BOT. The morbidity of the procedure was assessed with a visual analogue scale, and efficacy by separate questionnaires and sleep registration. The volume changes induced by the procedure were evaluated with cephalometric radiographs (CRs). Results. Twelve males and one female with a median age of 50 years (range 41–62) entered the study. Six patients (46%) had more postoperative swelling in the upper airway than expected. Three patients were defined as cured. The trend in the questionnaires was clear, but not significant. In the soft tissue airway CR measurements no significant changes were encountered, although a trend towards volume reduction was seen in the posterior airway space measure.

• RFA
• OSAS
• hypertonic saline
• tongue base