The technical simplicity and relative tolerability of TCRF tongue reduction could make it an appealing option for practitioners and for patients with multilevel obstruction as an initial site-directed operation in combination with UPPP.
* Does the addition of TCRF tongue reduction to UPPP add to the risk of adverse effects or to the degree of discomfort?
Treatment consisted of an initial operative procedure under general anesthesia in which all patients underwent traditional surgical UPPP, along with removal of the tonsils (if present), septoplasty (if indicated), and turbinate reduction (either surgical submucosal resection or TCRF tongue--reduction, depending on the type of turbinate obstruction).
Subsequently, nine of the 10 remaining patients in group 2 underwent two additional in-office TCRF tongue reductions under local anesthesia; these repeat TCRF tongue-reduction procedures were spaced 3 to 6 weeks apart.
The subsequent in-office TCRF tongue reductions administered to the nine patients in group 2 under local anesthesia were well tolerated, and most of them were able to return to normal activity within 24 hours (table).
All patients in both groups, including the one patient in group 2 who underwent only one TCRF procedure, reported subjective improvement in their OSAS symptoms (figure).
Foremost among them is that the addition of TCRF tongue reduction to UPPP does not appear to significantly increase the degree of pain and morbidity or the incidence of complications compared with UPPP alone.