Abstract
Problem
We investigated the topographic anatomic characteristics of the human tongue in order to determine the safest location for Coblation® (ArthroCare Corp., Sunnyvale, CA) tongue treatment in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and to provide detailed anatomic data to facilitate the surgery.
Methods
We dissected 16 lateral tongues from human cadavers and studied the distribution of the hypoglossal nerve and lingual artery and their respective distances. The ratios of those distances to the length and width of the tongue were calculated to establish the safest locations for Coblation tongue treatment.
Results
The vertical distance from the hypoglossal nerve and lingual artery to the surface of the tongue was invariant near the foramen caecum. The ratio of the horizontal distance from the hypoglossal nerve and lingual artery to the midline of the tongue to its length and the vertical distance to the surface at the foramen caecum and at 10 mm and 25 mm from the apex was obtained. Analysis of the data using ANOVA (analysis of variance) revealed statistically significant differences (p<0.05).
Conclusion
Low-temperature radiofrequency tongue treatment (Coblation) offers a safe and effective treatment for patients with retroglossal OSAHS. Recognizing the topographic anatomic characteristics of the tongue and applying the concepts of ratio and individualization, in which consideration is given to each patient's unique anatomy, promotes greater safety and optimal patient outcomes.
Significance
The data could extend the area of surgery in tongue from before or after caecum to the whole tongue. It could facilitate the coblation tongue treatment which is different from those surgeries in the base of tongue. And coblation tongue channeling (CTC) is very useful to treat hypertrophic tongue in obstructive sleep apnea syndrome (OSAS). We have performed many CTC on the patients with OSAS and give the relative area by proportional view in the tongue based on the data.
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