base of tongue reduction
Dr. Falk, a sleep surgery specialist, performs a number of base of tongue reduction procedures to create volumetric shrinkage of the tongue to assist in the treatment of obstructive sleep apnea.
The area at the base of the tongue (BOT) is a common site of obstruction in sleep apnea. The tongue base can crowd the airway and fall backwards when sleeping to create blockage. Anatomic features contributing to the fullness in this region includes the intrinsic tongue muscles, and tonsillar tissue called lingual tonsils as well. Volumetric reduction of the tongue base can be accomplished several ways:
One option in radiofrequency reduction using a needle inserted into the deep muscles of the tongue . This often referred to by the brand name Somnoplasty of the tongue base. The procedure can be done under general anesthesia or as an office procedure. In either way, first the tongue base behind the taste buds is anesthetized with a local anesthetic. Then a protected tip needle probe is inserted in the musculature of the tongue and kept in place for a few minutes whild a radiofrequency pulse is delivered to cause a subsurface injury which heals by contraction and thus shrinkage of the tongue. The needle is spaced in a number of locations per session, and more than one session is generally required with each session separated by a minimum of six weeks.
Additional options for volumetric reduction of the base of tongue is direct shave or excision of tongue base tissue. This is an endoscopic assisted procedure.
Robotic tongue base reduction is an extension of endoscopic assisted tongue resection incooperating robotic arms to assist in the accurate removal of tongue tissue. A relatively new procedure, it appears to demonstrate tremendous promise for the surgical treatment of sleep apnea.