Radiofrequency Palatal Myoplasty (RPM), also known as Radiofrequency Ablation
Radiofrequency Palatal Myoplasty (RPM), Also known as Radiofrequency Ablation (RfA), and Submucosal Radiofrequency Uvulopalatoplasty (SRUP), it has been used in urology, cardiology, and neurology as well as for liver tumor ablation. It provides tissue ablation (destruction) in a very precise and controlled manner. In RPM it is applied submucosally to partially ablate the muscle of the soft palate in a series of treatments, with resultant thinning (volumetric reduction) and stiffening (fibrosis with contraction) of the muscle layer (10). It was first described by Dr. N.B. Powell from Stanford University, California (6). It has been effective in controlling snoring and reducing daytime somnolence in mild sleep disordered breathing. Powell documented palatal shrinkage following the procedure.
Coleman 7 showed a reduction of snoring to a level which was no longer disturbing to the bed partner in 75% of treatment recipients. The Epworth sleepiness scale 26,27 measurement of subjective daytime somnnolence also improved. All studies have shown minimal post-operative symptoms relating to inflammation, and minimal complications. Significant improvement in obstructive airway parameters has not been consistently demonstrated (10,15) with palatal RPM alone. However the tongue base radiofrequency myoplasty has shown improvement in respiratory distress index (RDI) and is under investigation (16). More recent RPM studies have shown bed partner satisfaction rates of 77 - 96 % (17,19,25), with minimal pain compared to UPPP and LAUP (21). Follow up studies are few as yet but some relapse as in UPPP and LAUP is likely: further RPM treatment however can be expected to be both acceptable to the patient and successful in correcting any relapses (22). Instruments used to generate and transfer radiocautery do not need to be highly sophisticated and expensive (25).