(A1210) From Snore to Silence: Ventral-Only Ablation for Obstructive Sleep Apnea

Introduction: Continuous positive airway pressure (CPAP) remains the gold standard for Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS) management. However, patient intolerance to CPAP necessitates alternative treatments. This study evaluates the effectiveness and safety of ventral-only ablation of the tongue (VOAT), a novel radiofrequency ablation (RFA) technique, as an adjunct therapy for patients with moderate to severe OSAHS.

Methods: This retrospective case series included 55 patients (19 F, 36 M) with moderate/severe OSAHS intolerant to CPAP, treated with VOAT between March 2011 and September 2012. Pre and post-operative AHI scores for all 55 patients were compared to evaluate outcomes and significance. Patients were then subdivided into two groups: group 1, defined as patients whose AHI improved by >1.0 following the VOAT procedure (n=39), and group 2, patients whose post-procedure AHI either increased or did not decrease by >1.0 (n=16). Paired t-tests were used to assess statistical significance, with a threshold of p < 0.05.

Results: For all 55 patients (groups 1 and 2 combined), the mean pre-and post-operative AHI scores were 37.96/hr and 26.98, respectively, with p-values of 0.00006 (one-tailed) and 0.00011 (two-tailed). The average number of VOAT procedures was 4.44. 71% of patients fell into group 1. Pre & post-operative AHIs were 37.07/hr and 17.84/hr respectively. With p-value < 0.05, group 1 had a mean improvement of 19.23 points. In group 2 (n=16) 29% of responders had mean AHI values of 40.48/hr and 50.23/hr, with a p-value < 0.05. This non-responding group showed a mild worsening of apnea events. Pearson correlations were 0.688 for all patients.

Conclusions: VOAT demonstrates significant improvements in PSG. 71% of patients showed significant improvements from the procedure, while 29% showed no improvement. These findings suggest that VOAT may be a viable, minimally invasive, and cost-effective alternative to other OSA treatments, such as hypoglossal nerve stimulators for select patients. Further studies are needed to evaluate long-term efficacy and refine patient selection criteria.