To investigate, in a porcine tongue model, the lesions created by coblation to define the optimal application of this method in treating the enlarged tongue base in patients with obstructive sleep apnea syndrome.
A prospective, experimental animal study.
Military medical center.
Fifteen fresh porcine tongue specimens were injected with normal saline, and a single coblation probe was applied to the tongue specimens to create multiple submucosal lesions at specific energy settings. Control lesions were created without the use of saline injections. After creating the lesions, the porcine tongue specimens were sectioned and examined grossly. Size and character of lesions were recorded for each of the specimens and were compared across energy settings.
The energy applied at each setting was calculated on the basis of watts multiplied by treatment time. Coblation with saline injection created visible lesions with an average lesion area of 1.20 to 2.87 cm(2). The average lesion area increased as setting increased. Without saline injection, the average lesion area was 0.15 to 0.8 cm(2).
The porcine tongue model describes the relationship between lesion size and cold ablation device settings. Setting, but not time, significantly affects lesion size. The coblation setting and treatment time directly impact the amount of energy delivered. Additionally, submucosal normal saline injection significantly increases lesion size at all settings and application times. Given the average lesion diameter described in this study, placing lesions 1 cm apart will optimize the area affected by coblation while minimizing lesion overlap.
"While this performance is attractive for oromucosal systemic drug delivery, it is undesirable in terms of inputs of hazardous substances, among others, also synthetic dyes. Ge et al. (2009) and Salinas and Barrera (2010) confirmed that ex vivo porcine tongue is an excellent model for otolaryngology studies, but we found no relevant papers about its suitability for in vitro absorption measurements. Since according to Jacobi et al. (2005), a porcine snout is a good surrogate for human lips in permeability evaluation, we believe that the dorsum of the porcine tongue was a good choice for examining in vitro permeability of dyes in this study. "
[Show abstract][Hide abstract] ABSTRACT: Currently, there is evidence of health risks of triphenylmethane dyes after systemic absorption. This paper investigates the fate of Brilliant Blue (BB) and Patent Blue (PB) after 24-h in vitro diffusion, firstly through intact and secondly through shaven pig-ear skin (stored by freezing) from four leave-on cosmetics under in-use conditions. Both dyes showed no measurable permeation through intact skin but significant permeation was found through shaven skin. From 250 ng/cm2 of dye in one applied dose there were found 52 ng/cm2 of BB and 91 ng/cm2 of PB from ethanol-based after-shave, 39 ng/cm2 of BB and 86 ng/cm2 of PB from ethanol-free facial-cleanser, 35 ng/cm2 of BB and 43 ng/cm2 of PB from O/W emulsion, and no amount from W/O emulsion, as available to become systemically absorbed. Thirdly, the paper focuses on lingual mucosa after licking lollipops. Ex vivo porcine tongue dorsum was exposed to human saliva with 15000 ng/cm2 of dye for 20 min. 24-h diffusion resulted in 34 ng/cm2 of BB and 86 ng/cm2 of PB which can be directly absorbed into the blood system. Findings are troubling, particularly with regard to the frequent use of after-shave products by the male population and repeated lollipops licking by children.
Food and chemical toxicology: an international journal published for the British Industrial Biological Research Association 11/2012; 52. DOI:10.1016/j.fct.2012.10.027 · 2.90 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The pig represents a useful, large experimental model for biomedical research. Recently, it has been used in different areas of biomedical research. The aim of this study was to review the basic anatomical structures of the head region in the pig in relation to their use in current research. Attention was focused on the areas that are frequently affected by pathological processes in humans: the oral cavity with teeth, salivary gland, orbit, nasal cavity and paranasal sinuses, maxilla, mandible and temporomandibular joint. Not all of the structures have an equal morphology in the pig and human, and these morphological dissimilarities must be taken into account before choosing the pig as an experimental model for regenerative medicine.
[Show abstract][Hide abstract] ABSTRACT: Study objectives:
To investigate the surgical outcomes and efficacy of modified uvulopalatopharyngoplasty (mod UPPP) and Coblation channelling of the tongue (CCT) as a treatment for obstructive sleep apnea (OSA).
Adult patients with simple snoring or obstructive sleep apnea were treated with combined modified UPPP, bilateral tonsillectomy, and CCT (N = 48). Full polysomnography was performed preoperatively and 3 months postoperatively. Postoperative clinical assessment, sleep questionnaires, and patient demographics including body mass index were compared to preoperative data. All polysomnograms were re-scored to AASM recommended criteria by 2 sleep professionals.
The preoperative AHI (median and interquartile range) of 23.1 (10.4 to 36.6) was lowered to a postoperative AHI of 5.6 (1.9 to 10.4) (p < 0.05). The Epworth Sleepiness Scale score fell from 10.5 (5.5 to 13.5) to 5.0 (3.09 to 9.5) (p < 0.05). Morbidity of the surgery was low, with no long-term complications recorded.
Modified UPPP combined with CCT is a highly efficacious intervention for OSA with minimal morbidity. It should be considered for individuals who fail or are intolerant of CPAP or other medical devices.
Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine 02/2013; 9(2):117-124. DOI:10.5664/jcsm.2402 · 3.05 Impact Factor
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