sleep surgery-palatal implant

7/30/2019 sleep surgery-palatal implant

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Palatal implant


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Palate stiffening

An effective treatment for mild to

moderate minimally invasive procedure


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(primary palatalsnoring)

Friedman

(palatalposition) grade I II

OSA


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.


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Radiofrequency ablation;

soft palate and tongue base


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SPRF palatal component

Webbing

TBRF Retroligual collapse


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- OSAS

palatal component

(

21 7

stop)


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Radiofrequency tongue base ablation(RFA)decreases upper airway collapse by

producing a volumetric reduction in tonguebase tissue via the generation of scar tissue.

Insulated probe -> radiofrequency energy->introduced into several areas of the tonguebase and produces coagulation necrosisand healing by scar.

Performed in an outpatient setting under

local anesthesia and may required multipletreatments to achieve desired results

Cummings 259


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A review of 11 series showed successrates from 20% to 83% with multiple RFAapplications and concluded that this

procedure is not adequate as a soletreatment method, especially in light ofthe fact that most patients required

multiple sessions.

Cummings P259


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Plasma-mediated ablation

Probe 1.5cm .

10~15/lesion ablation 3-6

4-6 1-2


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Radiofrequency Volumetric Tissue Reduction of the Soft Palate: A New Treatment for SnoringBrian E. Emery MD, Phillip B. Flexon


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Midline glossectomy


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Midline glossectomy

retrolingual

airway.

.

Tongue base procedure retrolingual

collapse or narrowing .


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.


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suture

.

.

2/3 monopolar incision

suture.

Coblator wedge .

.


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Tongue base procedure Partial midline glossectomy(PMG),

lingualplasty, and radiofrequency tonguebase ablation : retrolingual collapse ornarrowing

Lingual tonsillectomy may helpful in patient

with lingual tonsillar hypertrophy. PMG creates a larger retrolingual airway by

removal of a midline rectangular strip of theposterior half of the tongue.

Lingual tonsillectomy, reduction of thearyepiglottic folds, and partialepiglottectomy are also performed.

Cummings 259page


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Pain : controlled with the multimodalanalgesia regimen.

Minor bleeding

Residual midline tongue defect

Dysphagia

Transient taste change *CPAP was more tolerable


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Anatomic landmarks


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Clinically oriented anatomy,P1005,LWW


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Clinically oriented anatomy,P1005,LWW


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Staging of Obstructive Sleep Apnea/Hypopnea Syndrome: A Guide to Appropriate Treatment

Michael Friedman, MD; Hani Ibrahim, MD; Ninos J. Joseph, BS


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sleep surgery-palatal implant

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