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The Surgical Management of Snoring and Obstructive Sleep Apnoea
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Bhik Kotecha, Mohamed Reda Elbadawey
The main advantages of this technique are that it can be carried out under local anaesthesia and used at multiple levels. For the soft palate, using the somnus device, three channels are made in each side of the soft palate in addition to two lesions in the paramedian position with the entry point just distal to the junction between the hard and soft palate. However, with the Celon device, which uses bipolar technology, more than three applications to the soft palate can be made. A special technique called coblation assisted upper airway procedure (CAUP) was described by Tvinnereim et al.46 This consisted of making a lateral palatal incision on each side, ablating three upward channels on each side of the midline (fan-shaped) into the soft palate, performing a partial uvulectomy with two upward channels in the uvula and finally channelling of the anterior and posterior pillars and the tonsils if they are present. Multilevel therapy of the palate, base of the tongue and tonsils was described, with a 33% improvement in OSA patients.101 The long-term success rate of radiofrequency treatment to the palate was found to be 37%.102 A recent review reported better visualization of the tongue base for the application of the probe by applying simultaneous pressure over the mylohyoid and the thyroid cartilage.103 It also emphasized the point that general anaesthesia may be the preferred option if multilevel application of radiofrequency is needed to treat the soft palate and the tongue base simultaneously.
Albucasis (936–1013), a pioneer in tonsillectomy
Published in Acta Chirurgica Belgica, 2022
Narges Tajik, Maryam Mohseni Seifabadi, Nasrin Musakazemi, Arman Zargaran
Detailed anatomical and histological studies were done in the nineteenth century. The German Hildanus in 1646 and Heister, the German anatomist, in 1763 presented devices like a guillotine-cutter for uvulotomy. The Frenchman Pierre Desault used a metallic device developed to break up bladder stones in 1770. This half-moon-shaped instrument had a small knife in its extremity. In the nineteenth century, Joseph Beck from the United States was first to describe the use of a device with a cutting wire inside a rigid ring known as Beck-Mueller’s ring [10].
Comparison of radiofrequency and transoral robotic surgery in obstructive sleep apnea syndrome treatment
Published in Acta Oto-Laryngologica, 2018
Engin Aynacı, Murat Karaman, Burak Kerşin, Mahmut Ozan Fındık
Twenty patients treated with anterior palatoplasty and uvulectomy−/+ tonsillectomy + RF (17 males, 3 females) and 20 patients treated with anterior palatoplasty and uvulectomy−/+ tonsillectomy + TORS (16 males, 4 females) were included in our study. The mean age of the patients who received RF was 41.7 ± 8.4 years. The mean age of patients treated with TORS is 45.0 ± 7.1 years.