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Permalink Reply by Mike on February 1, 2009 at 3:34pm

It's an outpatient procedure during which, under local anesthesia, a surgeon inserts a needle into the palate or the tongue and delivers microwave heat to shrink the tissue, the notion being that the shrinkage will make the airway less crowded, and less likely to lead to obstructed breathing. I gather it may require between 3-4 separate treatments, and the success rate hovers between 40-50%. Complications include throat pain, bleeding, infection, voice change, dryness of the mouth. Also the tissue may regrow after 3 years and may require repeat procedure.

Personally, I'd go with CPAP over this, but i know some folks have a really hard time with CPAP.

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Permalink Reply by Henning on February 1, 2009 at 4:10pm

Hi deb,

I have got a nose surgery for about 2 months ago. It was carried out under full anesthesia and consisted of a sinus surgery, a correction of my septum and a Coblation at my turbinate’s.

This Coblation is a Somnoplastic "surgery" to shrink the tissue under the mucus in my turbinate’s. It was a great success, but as Mike describes, the Coblation probably has to be repeated after 3 to 4 years.

But this procedure takes only about 10 minutes in local anesthesia.

Henning

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Permalink Reply by Steven Y. Park, MD on February 1, 2009 at 9:52pm

Somnoplasty is a brand name of a range of procedures marketed by Somnus. Using radiofrequency energy, the nasal turbinates, the soft palate, or even the tongue can be treated. There are many other companies and brands that do similar things. In essence, a needle probe is inserted into the desired area and a controlled burn is administered, with the total number of energy or jules calculated and displayed. Typically, with the soft palate and tongue, multiple treatment sessions are needed for significant effectiveness (2-3 for the palate and 4-5 for the tongue).

It's fallen out of favor more recently as patient don't want to follow-up for multiple sessions, and I returned my unit years ago for similar reasons. There have been more aggressive treatment regimens to cut down on the number of treatments, but with more side effects.

The end result is that scarring of the soft tissues occur with eventual gradual shrinking of the soft tissues. It's most useful as an outpatient procedure under local anesthesia, but can also be done in the OR along with other procedures.

Coblation is another radiofrequency product with similar applications, but it's different in that the energy that's applied creates a plasma field, vaporizing and excising tissue.

These procedures "success" depends on how aggressive you are and where you do the procedure. Since it's a minimally invasive procedure with less complications (in theory), you'll get less than optimal results. To get optimal results, you need to perform multi-level surgery (nose, palate and tongue). Somnoplasty procedures are most useful as an adjunctive procedure.

I've started using coblation to perform minimally invasive submucosal partial glossectomies, and the results are promising. However, more large scale studies are needed. You're actually physically debulking the tongue base area. It's also known as a SMILE procedure (submucosal intra-lingual excision described by Dr. Eric Mair).

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