Ventral-Only Ablation of the Tongue

Objective. To evaluate the effectiveness of Ventral-Only Ablation of the Tongue (VOAT) as a low-risk, office-based alternative to Continuous Positive Airway Pressure (CPAP) and uvulopalatopharyngoplasty (UPPP) for treatment of refractory Obstructive Sleep Apnea (OSA). 

Study Design. A retrospective case review.

Methods. 709 patient records were examined covering 2012 through 2025. Data included BMI, apnea-hypopnea index (AHI), oxygen desaturation index (ODI), lowest oxygen saturation (nadir SpO₂), arousal index (AI), and Epworth Sleepiness Scale (ESS). VOAT was performed using ventral radiofrequency ablation. 

Results. 709 patients (mean age 67.16 years, 66% male, 34% female) underwent VOAT treatment, with 216 patients completing both pre- and post-operative polysomnography and 524 patients (74%) completed post-operative ESS questionnaires. On average, BMI decreased by 0.44, AHI decreased by 3.18 events/hr (P = 0.001), ODI by 6.84 events/hr, and ESS improved by 4.2 points (P < 0.001). Overall, using Sher criteria (≥ 50% reduction and postoperative AHI < 20), 40.74% met the definition for clinically significant improvement in OSA. 21.76% of patients experienced no reduction in AHI and 32.85% experienced less than 50% reduction in AHI. By final AHI, 20.37% were complete responders (AHI  5), and 39.81% achieved AHI  10. Because definitions for outcomes represent overlapping classifications, the groups are not mutually exclusive, so they do not add to 100%. Overall, 78.3% of patients improved. Patients averaged 2.71 ablations. No major complications were observed.  

Conclusions. With significant improvements in sleep measurements, VOAT represents a potential minimally invasive alternative to traditional OSA treatments that warrants further investigation