Comparison of Minimally Invasive Techniques in Tongue Base Surgery in Patients with Obstructive Sleep Apnea

Babademez, Mehmet Alı; Yörübulut, Mehmet; Yürekli, Müge Fethiye; Günbey, Emre; Baysal, Selcan; Acar, Baran; Karaşen, Rıza Murat

doi:10.1177/0194599811414793

Cited by 24 publications

(20 citation statements)

References 33 publications

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“…Other minimally invasive procedures could be used that are less expensive with possibly less complications, such as submucosal excision of the base of the tongue, lingual tonsillectomy, or radiofrequency ablation of the tongue base. 18 Multilevel surgery did not result in a greater success rate than single-level surgery in our study. Guilleminault et al proposed that there may be an underlying neurologic component in the oropharyngeal and hypopharyngeal musculature resulting in collapse.…”

Section: Discussioncontrasting

confidence: 42%

“…Transoral robotic surgery was the chosen procedure when hypopharyngeal obstruction was noted, which resulted in increased costs. Other minimally invasive procedures could be used that are less expensive with possibly less complications, such as submucosal excision of the base of the tongue, lingual tonsillectomy, or radiofrequency ablation of the tongue base …”

Section: Discussionmentioning

confidence: 99%

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Clinical analysis of drug‐induced sleep endoscopy for the OSA patient

et al. 2015

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Section: Discussioncontrasting

confidence: 42%

Section: Discussionmentioning

confidence: 99%

Clinical analysis of drug‐induced sleep endoscopy for the OSA patient

et al. 2015

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“…Sleep apnea was severe in all studies, and statistically significant improvement in EDS was seen in all groups. Surgical success results were not reported for one study . In the random‐effects model comparing difference in mean preoperative to postoperative AHI, a decrease in AHI favoring surgical treatment was found, with a value of −21.30, a 95% CI of −29.75 to −12.85, and an I 2 of 76% (Fig.…”

Section: Resultsmentioning

confidence: 97%

Multilevel Palate and Tongue Base Surgical Treatment of Obstructive Sleep Apnea: A Systematic Review and Meta‐analysis

et al. 2019

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Objective: To evaluate multilevel palate and tongue base surgery as a method of treatment of obstructive sleep apnea by comparing the pre-and postoperative apnea-hypopnea index.Methods: We conducted a systematic review. MEDLINE and Embase databases were searched in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for conducting systematic reviews. Two authors screened all articles and performed methodological quality assessment. Relevant articles where reviewed in detail. Standard inclusion criteria were applied for article selection. Relevant data were extracted and summarized, a difference of means random-effects model was performed. Our primary outcome measure was change in apnea-hypopnea index pre-/postsurgical treatment.Results: Of 1,172 studies identified from January 2006 to March 2017, 46 studies met inclusion criteria and were included in the systematic review. This included 11 surgical subgroups and 1,806 patients. Methodological quality and risk of bias assessments were completed. There was strong male predominance 86.8 (standard deviation [SD] = 10.3%), and the average age was 46.8 (SD = 4.0) years. All studies included overweight to obese patients (average body mass index = 29.1 [SD = 3.5]). The average preoperative apnea-hypopnea index was 39.0 (SD = 15.4), and the average postoperative apnea-hypopnea index decreased to 18.3 (SD = 7.5). Meta-analysis data yielded a decrease in apnea-hypopnea index of −23.67 with a 95% confidence interval of −27.27 to −20.06.Conclusions: Non-maxillomandibular advancement, multilevel surgical procedures for obstructive sleep apnea demonstrate significant improvements in reduction of apnea-hypopnea index following surgery in addition to improvement in many other sleep-specific outcomes. Future research should include larger, higher-level studies that compare surgical treatments and identify factors associated with outcomes.Key Words: Obstructive sleep apnea, surgical treatment of obstructive sleep apnea, sleep medicine, sleep apnea, quality of life.

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“…There are published previous reports of our surgical experiences dealing with TORS and coblation. These surgeries were done by two different surgeons with similar surgical experiences of more than 5 years in TORS and 10 years in coblation . One of the surgeons performed TORS, other one performed endoscope guided coblation tongue base resection.…”

Section: Methodsmentioning

confidence: 99%

Prospective randomized comparison of tongue base resection techniques: Robotic vs coblation

Babademez

Gül

Sancak

et al. 2019

Clinical Otolaryngology

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Objective The objective of this study was to determine the effectiveness and morbidities of two different tongue base surgical approaches in patients with obstructive sleep apnoea (OSA). Design and Setting We carried out a prospective analysis in order to understand in detail the relative impact on apnoeas of the two different tongue base procedures. Seventy cases in 85 patients with OSA were divided into two operating groups and randomized. Altogether, 37 transoral robotic surgeries (TORS) and 33 coblations were performed. The patency of retrolingual passage was investigated by Muller's manoeuvere, polysomnography. Apnoea‐hypopnea index (AHI) was the primary outcome measure with the Epworth Sleepiness Score (ESS). The final follow‐up visit was at 6 months. Results The AHI index improved from 29.7 ± 9 to 10.7 ± 3.9 (P < .005) following TORS and from 27.2 ± 6.4 to 10.3 ± 4 in the coblation group. Selecting a threshold of a 50% reduction in AHI and AHI less than 20 events/h, the overall success rate was 75.6% in TORS compared with 78.7% in coblation (P = .785). Similar results were seen in AHI reduction rates (36%, 37.8%, respectively). ESS showed a significant improvement 6 months following surgery in both groups. Conclusion Transoral robotic surgery technique showed higher complication rates than coblation. TORS and coblation of the tongue base represent a promising treatment option with a similar AHI improvement. However, coblation promises lower complication rates unlike TORS.

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Comparison of Minimally Invasive Techniques in Tongue Base Surgery in Patients with Obstructive Sleep Apnea

Abstract: When the PSG findings and MRI were evaluated, UPPP + SMILE-R were found to be more effective. No significant difference was found between the 3 techniques when morbidity and complications were compared.

Cited by 24 publications

References 33 publications

Clinical analysis of drug‐induced sleep endoscopy for the OSA patient

Clinical analysis of drug‐induced sleep endoscopy for the OSA patient

Multilevel Palate and Tongue Base Surgical Treatment of Obstructive Sleep Apnea: A Systematic Review and Meta‐analysis

Prospective randomized comparison of tongue base resection techniques: Robotic vs coblation

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