GlideScope video laryngoscope-assisted tongue base radiofrequency for the treatment of obstructive sleep apnea: pilot study.

OBJECTIVE: The aim of this study was to evaluate the advantages and feasibility of using the GlideScope video laryngoscope (GSVL) (Saturn Biomedical Systems, Burnaby, BC) in radiofrequency tongue base reduction for patients with obstructive sleep apnea syndrome (OSAS). METHODS: Patients suffering from mild to severe OSAS associated with predominant tongue base obstruction (grade 3-4 Mallampati score) confirmed with physical examination who applied to our clinic during the first half of 2007 were included in our study. Seven-watt bipolar radiofrequency was applied to each patient's tongue base assisted by the GSVL at five to seven different locations for 30 to 35 seconds, resulting in energy application in a range of 210 to 245 J. All operations were carried out by the same surgeon, and patients were observed for 15 days postoperatively for any complications. RESULTS: Twelve patients were included in our study. Six of our patients were male and the other six were female. Each patient underwent a session of GSVL-assisted tongue base radiofrequency with a mean energy application of 210 to 245 J via five to seven punctures. The use of the GSVL assisted in a more thorough observation of tongue base anatomy, which aided in our aim to avoid the neurovascular bundle. The use of the GSVL during tongue base radiofrequency surgery creates a safer operation site and allows the surgeon to feel more confident during the procedure. The fact that we encountered no postoperative complications endorses our theory. CONCLUSION: The use of the GSVL in tongue base radiofrequency application not only creates a safer operative site and makes the procedure more uncomplicated but also could be an effective method that could be used in teaching hospitals for the education of otolaryngology surgeons regarding the tongue base radiofrequency procedure.

Comparison of radiofrequency applied to the total inferior choncha with application to its anterior third.

OBJECTIVE: To compare radiofrequency application to the anterior 1/3 of the inferior choncha with application to the whole of the inferior choncha. MATERIAL AND METHOD: 40 patients with nasal obstruction due to isolated inferior choncha hypertrophy were evaluated. RF was applied in the first group only to the anterior 1/3 of the choncha, whereas in the second group the whole choncha was ablated. Anterior rhinomanometry measurements were obtained both before and 6 weeks after surgery along with visual analog scales. Complete data was used to compare the efficacy of both techniques. RESULTS: The combined nasal resistance showed a significant decrease in both groups. VAS scores were also substantial for both groups. Both groups showed similar data proving the two techniques to have similar efficacy. CONCLUSION: Application to the anterior 1/3 compared with application to the whole of the choncha show no significant differences. Simple RF application here not only provides adequate control but also is safer as there is less risk of interruption of continuity of the nasal mucosa.

Efficacy of Tonimer gel spray on postoperative nasal care after endonasal surgery.

OBJECTIVE: To investigate the effect of the addition of Tonimer gel spray into nasal mucosa care on nasal mucosal findings and patient comfort in the postoperative period of endonasal surgery. MATERIAL AND METHOD: 40 patients who underwent endonasal surgery were included in the study. For the postoperative nasal care, isotonic saline was applied to both nasal cavities, and subsequently, Tonimer nasal gel spray was additionally applied to the right nasal cavity. Patients were examined on the 2nd, 7th, and 15th postoperative days. The findings of the examinations were scored with respect to crusting and the patient nasal comfort was assessed using the visual analog scale (VAS). RESULTS: The VAS values which measure patient comfort and crusting were significantly lower on the Tonimer side compared to control (p < 0.01). CONCLUSION: Tonimer and saline combination was found to be superior to saline per se in decreasing crusting and improving patient nasal comfort in the postoperative period.