In otolaryngology two novel RF instruments have been developed addressing the shortcomings associated with classic electrosurgery: controlled tissue ablation (Coblation) and temperature controlled radiofrequency total volume reduction (Somnoplasty). Coblation involves placing closely spaced bipolar electrodes in a conductive media in approximation with the tissue of interest. A plasma layer is produced disrupting molecular bonds in the tissue. Resultant debris is washed away during intraoperative irrigation. Since plasma forms in the conductive media, not on the tissue directly, surface temperatures are reduced (40-70°C compared to >400°C) resulting in decreased collateral tissue damage. In Somnoplasty, high frequency RF energy is delivered using a needle inserted into tissue. Resistive heating occurs in the tissue surrounding the electrode leading to heat generation and temperature rise. Temperature change is monitored using integrated thermocouples providing a control signal to a microprocessor permitting modulation of energy delivery rate. Irreversible tissue damage occurs at a threshold temperature. The tissue itself generates heat and not the probe. This presentation will introduce the principles underlying Coblation and Somnoplasty, focusing on their utility in head and neck surgery and addressing how these technologies are used to treat disorders of the head and neck while reducing thermal injury and carbonization.

Date Published: 17 June 2002
PDF: 6 pages
Proc. SPIE 4609, Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems XII, (17 June 2002); doi: 10.1117/12.437916

Published in SPIE Proceedings Vol. 4609:
Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems XII
Lawrence S. Bass M.D.; Eugene A. Trowers M.D.; Kenneth Eugene Bartels D.V.M.; Udayan K. Shah M.D.; David S. Robinson M.D.; Lawrence S. Bass M.D.; Kenton W. Gregory M.D.; Kenneth Eugene Bartels D.V.M.; Lawrence S. Bass M.D.; Brian Jet-Fei Wong M.D.; Hans-Dieter Reidenbach; Lloyd P. Tate V.D.M.; Nikiforos Kollias; Abraham Katzir; Timothy A. Woodward M.D.; Werner T.W. de Riese; George M. Peavy D.V.M.; Werner T.W. de Riese; Kenton W. Gregory M.D.; Michael D. Lucroy D.V.M.; Abraham Katzir; Nikiforos Kollias; Michael D. Lucroy D.V.M.; Reza S. Malek M.D.; George M. Peavy; Hans-Dieter Reidenbach; David S. Robinson M.D.; Udayan K. Shah M.D.; Lloyd P. Tate V.D.M.; Eugene A. Trowers M.D.; Brian Jet-Fei Wong M.D.; Timothy A. Woodward M.D., Editor(s)