Royal National Throat, Nose and Ear Hospital, 330 Gray's Inn Road, London, UK.
Eur Arch Otorhinolaryngol. 2011 Dec;268(12):1829-36. doi: 10.1007/s00405-011-1634-7. Epub 2011 May 19.
Radiofrequency (RF) surgery has gained popularity as a safe and effective method for treating patients with snoring and mild obstructive sleep apnoea (OSA). Both interstitial and cutting radiofrequency energy may be used for multi-segmental management of the upper airway. Little is known about the effect of cutting radiofrequency energy on human soft palate. Excessive collateral injury may have an impact on tissue healing and functional outcomes. A histological analysis of specimens of human soft palate and uvula following resection with cutting RF energy was performed. In addition, ultrastructural analysis using scanning electron microscopy of excision margins was performed and compared with CO(2) LASER. Twelve patients were included. In ten patients, specimens of redundant uvula and faucial pillars were collected and underwent formal histological analysis. The maximum depth of tissue injury was 1 mm in two specimens and overall average depth of injury was 0.15 mm. Injury depth was independent of tissue subtype at the resection margin. Ultrastructural analysis demonstrated accurate incision when compared to CO(2) LASER. Cutting RF energy causes minimal collateral injury to the soft palate during resection for the treatment of snoring and mild OSA. A detailed knowledge of local effects on resection specimens allows accurate inference of in vivo tissue injury at the resection margin and may enable more precise prediction of healing patterns and repair.
射频（RF）手术已成为治疗打鼾和轻度阻塞性睡眠呼吸暂停（OSA）患者的安全有效方法。间质和切割射频能量都可用于上呼吸道的多节段管理。关于切割射频能量对人类软腭的影响知之甚少。过多的附带损伤可能会对组织愈合和功能结果产生影响。对使用切割 RF 能量切除后的人类软腭和悬雍垂标本进行了组织学分析。此外，还使用扫描电子显微镜对切除边缘进行了超微结构分析，并与 CO2 激光进行了比较。共纳入 12 例患者。在 10 例患者中，收集了多余的悬雍垂和咽旁柱标本并进行了正式的组织学分析。两个标本的组织损伤最大深度为 1 毫米，总体平均损伤深度为 0.15 毫米。损伤深度与切除缘的组织亚型无关。与 CO2 激光相比，超微结构分析显示准确的切口。在治疗打鼾和轻度 OSA 时，切割 RF 能量在切除过程中对软腭的附带损伤最小。对切除标本的局部影响有详细的了解，可以准确推断出切除缘的体内组织损伤，并可能更准确地预测愈合模式和修复。
