Application of hot knife for diseases in stomato-pharyngology

Application for obstructive sleep apnea

Abstract

Uvulopalatopharyngoplasty (UPPP) has been a golden standard for the treatment of simple snoring and mild obstructive sleep apnea (OSAS). Surgeons usually performed UPPP by a scalpel, which is socalled cold knife. Because the long-term success rate was approximately 50%, it is necessary to find a new surgical technique for simple snoring and mild OSAS. Recent technological advancement enables the use of special devices, such as high-frequency electric cautery, laser and ultrasonically activated scalpel, for the treatment of simple snoring and OSAS. We call these devices hot knives. Among the treatments using hot knives, the cautery-assisted palatal stiffening operation (CAPSO) and the radiofrequency volumetric tissue reduction (RFVTR) are introduced in this paper. CAPSO is a mucosal surgery that induces a midline palatal scar that stiffens the floppy palate. RFVTR is a nearly painless procedure that can deliver controlled radiofrequency energy into the soft palate for the treatment of habitual snoring and mild OSAS. The resulting submucosal necrotic lesions of RFVTR are intended to alleviate snoring through volumetric tissue reduction of the soft palate and shortening of the palate-uvula length. Two different methods are discussed in the present study.