Radiofrequency ablation in snoring surgery: local tissue effects and safety measures

Radiofrequency ablation is now widely used in the treatment of patients with snoring and obstructive sleep apnoea. It is well suited to the multilevel approach typically required in snoring surgery and can be used interstitially or in cutting mode. However, no research has been performed to analyse the collateral local tissue damage or size of lesions induced by radiofrequency application. This is the first study of the histological effects of interstitial radiofrequency. We studied the size of tissue lesions generated at differing power settings with and without local anaesthetic application in human tonsils and chicken breast tissue. The size of the lesion was independent of power setting and local anaesthetic infiltration. The typical effect was an oval-shaped lesion centred on the active electrode, 6-7 mm in width and 7-8 mm in length. This was confirmed histopathologically, with smaller lesions generated in the submucosa (2 × 3 mm) but with no collateral tissue damage beyond this distinct zone of injury. To avoid complications, we recommend placing contiguous radiofrequency applications at least 8 mm apart. Post-nasal space packing raises and tautens the soft palate. The use of local anaesthetic increases interstitial volume, thereby reducing the risk of incorrect probe placement and resultant ulceration or fistulation.