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Abstract
Over the last few years, different surgical techniques for the treatment of obstructive sleep apnea syndrome have been developed. Whilc nçw methods for the treatment of velopharyngeal obstruction turned out to the safe and effective, treatment of hypopharyngeal obstruction due to tongue base hypertrophy has remained, in many aspects, an unsolved problem. Surgical techniques for partial resection of the tongue base (midline glossectomy, lingualpiasty) are effective but very invasive procedures requiring temporary tracheotomy, and have high postoperative morbidity. A maxillofacial approach showed significant Teduction in the Respiratory Disturbance Index (RDI), especially when bimaxillar osteotomies are performed. Along with the concerns of pdstopertie morbidity, these techniques require general anesthesia and liospital ization.
The technique of tongue base suspension suture described the incisionIessplacement of a bone screw into the lingual cortex of the mandibuliw symphysis. An attached suture of proline is then looped into the posterior tongue base and tied anterioloy. When tightened, the suture supports the anterior hypopharyngeal airway and tongue base, theoreticaHy preventing obstruction. This technique had the advantage of being noriexcisional, potentially reversible, and a minor surgical procedure.
Tongue base reduction with temperature-controlled radiofrequency tissue ablation was introduced in 1998 and has proven to be a safe and simple procedure. Significant reduction in AHI has been shown in the majority of the treated patients.