Radiofrequency Volumetric Tissue Reduction of the Palate in Subjects With Sleep-Disordered Breathing: Evaluation of the variables of pain

26 May
2014

The evaluation of the variables of pain, speech, swallowing, and snoring was done by the use of VAS scoring. The subjective complaint from most surgical or laser procedures at the palate level is moderate to intense and often unremitting pain that usually requires a narcotic analgesic for 3 to 5 days and occasionally for up to 2 weeks. The posttreatment RF procedure was not reported as very painful by the subjects. However, overall, the subjects did experience restless sleep on the first posttreatment night in response to mild discomfort. No subject altered his or her daily routine or diet, and with subsequent treatments, there was less of a pain response noted. A narcotic was seldom used, and over-the-counter analgesics were used sparingly. canadian neighborhood pharmacy

The evaluation of speech and swallowing difficulties was included in this investigation, since these complications have a known occurrence with palatal surgery. When noted, they are usually associated with palatal incompetence after surgery or laser treatment. However, this complication is so difficult to repair that evaluation and avoidance strategies are essential for application of any new technology. All subjects reported minor speech and swallowing VAS scores at the far left (minimum) for the first 24 hours that resolved by 48 hours. The avoidance strategies used in this study were designed to limit total energy delivery, treatment time, and temperature. To further avoid the possibility of stenosis of the palate secondaiy to scarring, the treatment site was limited to the midportion of the palate where the thickness of the palate is at its maximum. Finkelstein et al has reported on the use of laser-assisted uvulopalatophaiyngoplasty (LAUP) causing narrowing of the palate due to scarring and retraction during healing.
The development of excessive heat by RF can result in unwanted tissue damage and subsequent scarring. However, analyzing the extent of heat distribution and subsequent tissue damage after RFe delivery was difficult due to the fact that the lesions created were below the surface and could not be visualized as they would be in an open surgical or laser procedure.

top