PALATE RADIOFREQUENCY

For more information about the selection of palate procedures, please see Dr. Kezirian's blog entry about choosing the best palate surgery for snoring and sleep apnea.

Palate radiofrequency is mainly a snoring procedure

Radiofrequency treatment of the soft palate is typically reserved for patients with simple snoring or upper airway resistance syndrome. Energy is delivered at 1-3 locations with a specially-designed probe to heat the soft tissues in a controlled fashion and create a certain amount of damage. The repair of that damage includes formation of a scar, and the tissues are tightened and reduced in size.

This procedure is performed in the office without requiring general anesthesia or sedation. Most patients undergoing radiofrequency treatment of the soft palate should expect two or three treatment sessions. Reducing the amount of treatment at each session reduces the risks of complication and allows the treatment to be tailored to the patient’s anatomy and their healing responses.

There are multiple radiofrequency technologies available, including the earliest one that was called Somnoplasty. Dr. Kezirian uses the latest studies to offer those that have the best tradeoff of good results and patient safety and comfort.

radiofrequency palate somnoplasty coblation image for snoring surgery
The probe in placed into the muscle
of the soft palate to deliver treatment.

radiofrequency palate somnoplasty coblation snoring surgery
The soft palate is treated.

postoperative image showing effect of palate radiofrequency for snoring treatment
Healing of the tissues causes shrinkage and tightening of the soft palate tissues.
This creates more space for breathing and reduces the ability of the
soft palate to produce snoring sounds.

The following video presents a discussion of palate procedures, including palate radiofrequency:


RISKS

Bleeding and infection
Bleeding and infection are rare after palate radiofrequency. Patients will rinse their mouth with an antiseptic prior to the procedure to reduce the risk of infection. Patients should not use mouthwashes following surgery because many of these contain alcohol which can irritate the lining of the mouth and interfere with healing. A major factor in preventing serious bleeding is to avoid the use of aspirin, NSAIDs (such as ibuprofen, Advil®, Motrin®, naproxen, or Aleve®), vitamin supplements, or herbal medications for at least two weeks before and after surgery.

Palate ulcer or hole
The goal of radiofrequency treatment is the creation of a controlled amount of damage underneath the surface lining of the palate. However, it is possible for the lining to be injured. If the lining is damaged on one side of the palate, an ulcer will develop; there is usually some increased pain. If both sides are involved a fistula, or hole, will develop. Fortunately both complications are rare and almost always heal by themselves over the course of days to weeks.

Difficulty swallowing
The palate is important in swallowing because it seals the back of the mouth from the back of the nose. The swelling and pain that occurs may make swallowing more difficult for 1-3 days. Rarely, patients may have foods, especially liquids, come up in the back of the nose or occasionally through the nose, but it is rare for any trouble with swallowing to be permanent.

Changes in speech
Any operation on the palate can cause changes in speech, but these changes are rarely permanent.

Throat dryness or feeling of something stuck in the throat
Any operation on the palate can affect the throat in unpredictable ways, and it is possible for some patients to dryness or a feeling that something is stuck in the throat. These are usually temporary, but they can be permanent.

Continued snoring:
The goal of palate radiofrequency is to reduce the loudness and frequency of disruptive snoring. However, many patients will continue to snore to some extent, even after successful surgery.


POSTOPERATIVE INSTRUCTIONS

NOTIFY DR. KEZIRIAN IMMEDIATELY IF YOU HAVE ANY TROUBLE BREATHING OR IF ANY BLEEDING DEVELOPS!

Pain control
You should be prescribed some narcotic pain medication after palate radiofrequency, but many patients obtain sufficient pain relief with acetaminophen (Tylenol®) alone. You should take either medication as you need it for pain control, and try not to let the pain increase until it becomes intolerable before you take the medication. Avoid aspirin, NSAIDs (such as ibuprofen, Advil®, Motrin®, naproxen, or Aleve), vitamin supplements, or herbal medications for at least one week because they can increase your risk of bleeding after surgery. Your pain will be noticeable for 2-3 days following the procedure, but it should improve markedly soon after. Let your doctor know immediately if you are experiencing significant or prolonged pain.

Diet
Due to the pain and swelling that is to be expected, you may have some trouble eating and drinking for 2-3 days following the procedure. Most patients are able to continue with their normal diet, but it is helpful to avoid very hot (temperature) foods for several days because these can increase the amount of swelling and discomfort.

Activity
Walking after surgery is important. Patients should walk at least three times a day starting the day after surgery. Walking helps prevent blood clots from forming in your legs. Spending more time out of bed (walking or in a chair) than in bed is helpful because your lungs fill up with air, lowering the risk of fevers and pneumonia. Not walking enough is a major cause of fevers after surgery, so please do remember to walk at least 3 times every day. Patients should avoid strenuous activity for 1 week following surgery because that typically raises heart rate and blood pressure. For this reason, it can increase swelling or cause bleeding to start.

Do not use mouthwashes, lozenges, or throat sprays
Patients should not use mouthwashes, lozenges, or throat sprays following surgery because many of these contain alcohol that can irritate the lining of the mouth or numbing medication that can expose you to a serious complication when used for more than a couple of times.

Ear problems or jaw discomfort
The swelling in your throat that occurs after surgery can cause jaw pain or ear symptoms such as pain, pressure, or fullness. This is common and should improve within 1-2 weeks following surgery. It occurs because the soft palate and tonsils are next to the jaw and the small Eustachian tube that connects the space behind the eardrum to the top of the throat. Swelling in the throat can interfere with your ability to clear or pop your ears, and it can also be sensed by your body as pain coming from your ears even though the ears are not affected (a phenomenon called referred pain).

Additional questions
Please call the Nurse line at 323-442-0190 with any questions during normal business hours. For after hours or weekends, please call the Call Center at 323-442-5790 to speak to the physician on call.