DESCRIPTION
Radiofrequency tissue volume reduction (e.g., Somnoplasty) utilizes low-power, low-temperature radiofrequency energy in the treatment of obstructive sleep apnea. The objective of radiofrequency tissue volume reduction (RFTVR) is to decrease the amount of redundant tissue in the soft palate, tongue, turbinates and tonsils. The procedure is performed in the physician's office using local anesthesia and takes approximately thirty minutes to complete. By means of a partially insulated electrode, radiofrequency energy is delivered into the area through the submucosal tissue to make one or several coagulation lesions. The treated tissue is naturally absorbed over the next four to eight weeks. The tissue volume is reduced and the area that is responsible for causing the obstructive sleep apnea stiffens. In some instances radiofrequency tissue volume reduction may need to be repeated depending on the severity of the individual's condition.
POLICY
Radiofrequency tissue volume reduction for the treatment of upper airway obstruction is considered investigational.
See also:
ADDITIONAL INFORMATION
Studies in peer-reviewed literature are lacking regarding whether RFVTR is as beneficial as medical management or other surgical procedures for the treatment of upper airway obstruction
SOURCES
BlueCross BlueShield Association. Medical Policy Reference Manual. (6:2007). Minimally invasive surgery for snoring, obstructive sleep apnea syndrome/upper airway resistance syndrome (7.01.101). Retrieved March 18, 2008 from BlueWeb. (21 articles and/or guidelines reviewed)
Cartwright, R., Venkatesan, T. K., Caldarelli, D., & Diaz, F. (2000). Treatments for snoring: A comparison of somnoplasty and an oral appliance. Laryngoscope, 110 (10 Pt. 1), 1680-1683. Abstract retrieved May 25, 2001 from PubMed database.
Cummings, C. W., Flint, P. W., Haughey, B. H., Robbins, K. T., Thomas, J. R., Harker, L. A., et al. (Eds.) (2005). Cummings: Otolaryngology: Head and neck surgery (4th ed., chapter 75). Philadelphia: Mosby. (63 articles and/or guidelines reviewed)
Hayes. Medical Technology Directory. (2005, September). Sleep apnea treatment, surgical. Retrieved March 18, 2008 from http://www.Hayesinc.com/subscribers. (77 articles and/or guidelines reviewed)
Hayes. Medical Technology Directory. (2007, March). Radiofrequency tissue volume reduction for the treatment of upper airway obstruction. Retrieved March 18, 2008 from http://www.Hayesinc.com/subscribers. (64 articles and/or guidelines reviewed)
Li, K. K., Powell, N. B., Riley, R. W., Troell, R. J. & Guileminault, C. (1998). Radiofrequency volumetric tissue reduction for treatment of turbinate hypertrophy: A pilot study. Otolaryngology-Head and Neck Surgery, 119 (6), 569-573. Abstract retrieved October 22, 1999 from PubMed database.
Loube, D. I. (1999). Technologic advances in the treatment of obstructive sleep apnea syndrome. Chest, 116 (5), 1426-1433.
Nease, C. J. & Krempl, G. A. (2004). Radiofrequency treatment of turbinate hypertrophy: A randomized, blinded, placebo-controlled clinical trial. Otolaryngology-Head and Neck Surgery, 130 (3), 291-299. Abstract retrieved December 2, 2004 from PubMed database.
Powell, N. B., Riley, R. W., & Guileminault, C. (1999). Radiofrequency tongue base reduction in sleep-disordered breathing: A pilot study. Otolaryngology-Head and Neck Surgery, 120 (5), 656-664.
Said, B., & Strome, M. (2003). Long-term results of radiofrequency volumetric tissue reduction of the soft palate for snoring. The Annals of Otology, Rhinology, and Laryngology, 112 (3), 276-279. Abstract retrieved December 2, 2004 from PubMed database.
Steward, D. L. (2004). Effectiveness of multilevel (tongue and palate) radiofrequency tissue ablation for patients with obstructive sleep apnea syndrome. Laryngoscope, 114 (12), 2073-2084. Retrieved July 18, 2006 from PubMed database.
The Technology Evaluation Center [Computer software]. (2000, December). Radiofrequency volumetric tissue reduction for sleep-related breathing disorders (Vol. 15, No. 15). Chicago: BlueCross BlueShield Association. (55 articles and/or guidelines reviewed)
U. S. Food and Drug Administration. (2000). Center for Devices and Radiological Devices. Class II special control guidance document for acute upper airway obstruction devices. Retrieved March 18, 2008 from http://www.fda.gov/cdrh/ode/guidance/1138.pdf.
ORIGINAL EFFECTIVE DATE: 6/1/2000
MOST RECENT REVIEW DATE: 5/8/2008
ID_BT
Policies included in the Medical Policy Manual are not intended to certify coverage availability. They are medical determinations about a particular technology, service, drug, etc. While a policy or technology may be medically necessary, it could be excluded in a member's benefit plan. Please check with the appropriate claims department to determine if the service in question is a covered service under a particular benefit plan. Use of the Medical Policy Manual is not intended to replace independent medical judgment for treatment of individuals. The content on this Web site is not intended to be a substitute for professional medical advice in any way. Always seek the advice of your physician or other qualified health care provider if you have questions regarding a medical condition or treatment.
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