Comparing Upper Airway Stimulation to Transoral Robotic Base of Tongue Resection for Treatment of Obstructive Sleep Apnea

Huntley, Colin; Topf, Michael C.; Christopher, Vanessa; Doghramji, Karl; Curry, Joseph; Boon, Maurits

doi:10.1002/lary.27484

Cited by 32 publications

(38 citation statements)

References 26 publications

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“…In January 2020, 76 articles were identified in a preliminary search, and 8 of these articles met the criteria for review 4,[11][12][13][14][15][16][17] . The results of QUADAS-2 assessment of the included articles are illustrated in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…2) and revealed a significant treatment effect in these studies (p < 0.05). Among the included studies, six were retrospective [11][12][13][14][15]17 , one had a pre-post-test design 16 , and one was prospective 4 . In total, 188 patients with obstructive sleep apnea treated with TORS and 230 cases treated with alternative interventions were included in the analysis.…”

Section: Resultsmentioning

confidence: 99%

“…In total, 188 patients with obstructive sleep apnea treated with TORS and 230 cases treated with alternative interventions were included in the analysis. Three studies investigated coblation tongue base resection (CTBR, total n = 79) [11][12][13] , and two studies investigated upper airway stimulation (UAS, total n = 105) 14,15 . Three articles reported on radiofrequency (n = 20), CO 2 laser (n = 10), and endoscopic partial midline glossectomy (EPMG, n = 16) 4, 16,17 .…”

Section: Resultsmentioning

confidence: 99%

“…These studies did not include pooled effect sizes of AHI for radiofrequency, CO 2 laser or EPMG. Six studies measured the lowest O 2 saturation before and after the operation 11,[13][14][15][16][17] . As illustrated in Table 4, a comparison of SMD in TORS revealed a significant increase in lowest O 2 saturation (increase in average lowest O 2 saturation from 79.83 to 86.81%; total random effect = 1.43, p < 0.05).…”

Section: Resultsmentioning

confidence: 99%

“…Articles without data on surgical outcomes, studies on only one particular operation, and reviews on TORS as a treatment for unrelated medical conditions were all excluded. Severity of sleep apnea was diagnosed using attended overnight polysomnography for each patient in the eight studies included, and the scoring system was defined by the American Academy of Sleep Medicine (AASM) 4,[11][12][13][14][15][16][17] . Babademez et al used the AASM 2.2 edition 12 , and Hwang et al and Lan et al used the AASM 2.5 edition to measure overnight PSG 11,13 .…”

Section: Openmentioning

confidence: 99%

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Comparison of transoral robotic surgery with other surgeries for obstructive sleep apnea

Tsou

Chang

2020

Sci Rep

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This study compared the characteristic surgical parameters and clinical effects of transoral robotic surgery (TORS) and other available methods used to alleviate obstructive sleep apnea. Articles on TORS and other surgeries for obstructive sleep apnea were identified in the PubMed and EMBASE databases. Two investigators independently reviewed the articles and classified the data for meta-analysis. The pooled effect sizes of TORS (standardized mean difference; SMD = − 2.38), coblation tongue base resection (CTBR; SMD = − 2.00) and upper airway stimulation (UAS; SMD = − 0.94) revealed significant improvement in the apnea–hypopnea index (AHI; p < 0.05). The lowest O2 saturation reported was significantly increased following TORS (SMD = 1.43), CTBR (SMD = 0.86) and UAS (SMD = 1.24, p < 0.05). Furthermore, TORS (SMD = − 2.91) and CTBR (SMD = − 1.51, p < 0.05) significantly reduced the Epworth Sleepiness Scale (ESS) score. No significant difference in operation time, success rate, or instances of complication were observed between TORS and the other compared interventions. The use of TORS in obstructive sleep apnea has the same rate of success and failure as other methods of surgical intervention for obstructive sleep apnea with no statistical difference in operation times. The reported clinical effects on the AHI, lowest O2 saturation, and ESS scores of TORS were similar to those of other surgeries.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Openmentioning

confidence: 99%

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Comparison of transoral robotic surgery with other surgeries for obstructive sleep apnea

Tsou

Chang

2020

Sci Rep

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International Consensus Statement on Obstructive Sleep Apnea

Chang

Goldberg

Alt

et al. 2023

Int Forum Allergy Rhinol

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Background: Evaluation and interpretation of the literature on obstructive sleep apnea (OSA) allows for consolidation and determination of the key factors important for clinical management of the adult OSA patient. Toward this goal, an international collaborative of multidisciplinary experts in sleep apnea evaluation and treatment have produced the International Consensus statement on Obstructive Sleep Apnea (ICS:OSA). Methods: Using previously defined methodology, focal topics in OSA were assigned as literature review (LR), evidence-based review (EBR), or evidencebased review with recommendations (EBR-R) formats. Each topic incorporated the available and relevant evidence which was summarized and graded on study quality. Each topic and section underwent iterative review and the ICS:OSA was created and reviewed by all authors for consensus. Results: The ICS:OSA addresses OSA syndrome definitions, pathophysiology, epidemiology, risk factors for disease, screening methods, diagnostic testing types, multiple treatment modalities, and effects of OSA treatment on multiple OSA-associated comorbidities. Specific focus on outcomes with positive airway pressure (PAP) and surgical treatments were evaluated. Conclusion:This review of the literature consolidates the available knowledge and identifies the limitations of the current evidence on OSA. This effort aims to create a resource for OSA evidence-based practice and identify future research needs. Knowledge gaps and research opportunities include improving the metrics of OSA disease, determining the optimal OSA screening paradigms, developing strategies for PAP adherence and longitudinal care, enhancing selection of PAP alternatives and surgery, understanding health risk outcomes, and translating evidence into individualized approaches to therapy.

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Surgical, clinical, and functional outcomes of transoral robotic surgery used in sleep surgery for obstructive sleep apnea syndrome: A systematic review and meta‐analysis

et al. 2021

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We investigated safety and efficacy of transoral robotic surgery (TORS) for base of tongue (BOT) reduction in obstructive sleep apnea syndrome (OSAS) patients. PubMed, Cochrane Library, and Scopus were searched. A meta‐analysis was performed. Random effects models were used. Thirty‐one cohorts met our criteria (1693 patients). The analysis was based mostly on retrospective studies. The summary estimate of the reduction of Apnea–Hypoxia Index (AHI) was 24.25 abnormal events per hour (95% CI: 21.69–26.81) and reduction of Epworth Sleepiness Scale (ESS) was 7.92 (95% CI: 6.50–9.34). The summary estimate of increase in lowest O2 saturation was 6.04% (95% CI: 3.05–9.03). The success rate of TORS BOT reduction, either alone or combined with other procedures, was 69% (95% CI: 64–79). The majority of studies reported low level of evidence but suggested that TORS BOT reduction may be a safe procedure associated with improvement of AHI, ESS, and lowest O2 saturation.

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Comparing Upper Airway Stimulation to Transoral Robotic Base of Tongue Resection for Treatment of Obstructive Sleep Apnea

Abstract: 3. Laryngoscope, 2018.

Cited by 32 publications

References 26 publications

Comparison of transoral robotic surgery with other surgeries for obstructive sleep apnea

Comparison of transoral robotic surgery with other surgeries for obstructive sleep apnea

International Consensus Statement on Obstructive Sleep Apnea

Surgical, clinical, and functional outcomes of transoral robotic surgery used in sleep surgery for obstructive sleep apnea syndrome: A systematic review and meta‐analysis

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