Submucosal tunneling of soft palate

Radiofrequency plasma knives are a kind of surgical technique. In 1974, Sweet and Wepsic used radio frequency (RF) to treat trigeminal neuralgia. Later, RF was gradually applied in the fields of cardiac surgery, urology, oncology, etc. In the past three years, it began. Applied to the Department of Otorhinolaryngology, the treatment of upper airway obstruction, including soft palate reduction, submucosal partial resection of the inferior turbinate and tongue reduction. The principle of RF action is to use bipolar technology to form a thin layer of plasma between the electrode and the tissue. The ions in the layer are accelerated by the electric field, and the energy is transmitted to the tissue, and the molecular bond is opened at a low temperature (<100 ° C) to make the target tissue. The cells in the body disintegrate in molecular units, decompose carbohydrates and oxygenates, causing tissue coagulative necrosis. The necrotic tissue is detached or scar contracted, and the effect of cutting or reducing the volume of the tissue is formed. Since the treatment temperature is not high and the RF treatment energy decays rapidly with increasing distance r, the damage is confined to the tissue surrounding the electrode. Therefore, RF treatment has the characteristics of minimally invasive surgery such as less damage, less bleeding, less pain, and less risk. Easy to accept for patients, has a good application prospects. Treatment of diseases: tonsillitis around the tonsils abscess Indication Soft submucosal tunneling is suitable for: 1.18 to 65 years old, habitual snoring or mild to moderate OSAS patients. 2. According to the positioning examination, the pharyngeal obstruction is located in the soft palate plane. 3. The tonsils are not hypertrophied or have been removed. 4. The squat is thick or soft and the free edge is low. 5. Patients with systemic serious illnesses who cannot tolerate surgery. Contraindications 1. The mandible is too small or has a history of soft palate surgery. 2. Those with coagulopathy. 3. Place the pacemaker. 4. Pregnant women. Preoperative preparation 1. Select the ENTec plasma surgery system to determine the output energy level in 4 or 5, and increase or decrease the output energy as appropriate according to the resistance encountered during the operation. 2. Patients should quit smoking and alcohol before surgery to keep the mouth clean and treat oral diseases. 3. For patients who are nervous before surgery, give sedatives as appropriate. Surgical procedure 1. Reflex plasma knife, physiological saline or saline gel, selected in the midline of the ankle, 1cm behind the junction of soft palate and hard palate, enter the mucosa vertically, start the working switch, and advance about 1.6cm under the mucosa to the root of the iliac crest. For 10 to 15 seconds, remove the Reflex plasma knife. 2. In the same operation, the submucosal advancement is performed obliquely on both sides of the first piercing point. complication 1. Pharyngeal puncture point bleeding or submucosal congestion, generally used in the operation of cotton ball compression to stop bleeding. 2. Pharyngeal edema, severe cases can be treated with CPAP.