Surgical ablation of lingual tonsils in the treatment of obstructive sleep apnea

Mure, C.; Blumen, M.; AlAli, Alaa; Page, L. Le; Chabolle, F.

doi:10.1016/j.anorl.2018.11.001

Cited by 13 publications

(12 citation statements)

References 28 publications

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“…These are all reason why our group is trying to develop new treatments for sleep disorder Recently, we demonstrated [23] in a prospective series of 40 patients that a non-surgical, minimally invasive outpatient Er: YAG laser treatment was effective in reducing snoring and improving the quality of sleep; these data are supported by the literature [24]. Diode lasers have been used for surgical treatment of sleep apnea [25,26]. However, to date, no study has been performed using an 808 nm diode laser device for non-ablative treatment of snoring and sleep disorders.…”

Section: Introductionmentioning

confidence: 71%

Snoring and Sleep-Related Symptoms: A Novel Non-Invasive 808 nm Wavelength Diode Laser Non-Ablative Outpatient Treatment. A Prospective Pilot-Study on 45 Patients

et al. 2021

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Background: Surgical treatments for snoring and sleep-related symptoms are invasive, may have complications, have inconstant success rates, and may have a significant relapse rate. Methods: We evaluated the effectiveness of a non-surgical, non-invasive outpatient 808 nm diode laser treatment. Forty-five patients with snoring and sleep disorders were treated with an Elexxion-Claros® 50W Diode Laser 808-nm using the specific SNORE3 application. The possible presence of obstructive sleep apnea syndrome in patients was diagnosed with Polysomnography. The Epworth sleepiness scale was reported pre- and post-laser treatments. Patients were classified according to both Friedman tongue position and Mallampati classification. During treatment, the pain reported by patients was measured on a visual analogue scale. Results: The following data improved significantly: visual analogue scale for the loudness of snoring, Epworth sleepiness scale, waking up during sleep because of snoring, dreaming during the night, dry mouth on awakening, daytime sleepiness, tiredness on awakening, Mallampati score, Friedman tongue position and degree of oropharynx at nose, oropharynx, hypopharynx, and larynx classification (p < 0.001). A cessation of choking in 89% of the patients and of restless legs syndrome in 83% of the patients (p ≤ 0.005 and p ≤ 0.025) was also noted after the laser treatments. All of the patients who reported suffering from headaches upon waking (10 subjects) reported the complete cessation of this phenomenon after laser therapy. Conclusions: diode laser treatment is a promising procedure not only in reducing the loudness of snoring, but also in raising the global quality of sleep, a statistically significant reduction of AHI, and a cessation of bothersome phenomenon related to apnea. Results were sustainable at one year post-treatment.

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Section: Introductionmentioning

confidence: 71%

Snoring and Sleep-Related Symptoms: A Novel Non-Invasive 808 nm Wavelength Diode Laser Non-Ablative Outpatient Treatment. A Prospective Pilot-Study on 45 Patients

et al. 2021

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“…Of these, 84.0% were male and 16.0% were female. Only 1 study 29 had more female subjects than male (5 males vs 6 females), and 1 study 30 comprised 50% male and 50% female participants. The remainder of studies (98.6%) featured a majority of male patients, with 11 studies exhibiting 100% males 31–41 .…”

Section: Resultsmentioning

confidence: 99%

Representation of Race and Sex in Sleep Surgery Studies

Debbaneh¹,

Ramirez

Block‐Wheeler³

et al. 2022

Otolaryngol.--head neck surg.

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Objective Obstructive sleep apnea (OSA) is a highly prevalent disorder with many treatment modalities, including surgical intervention. While OSA is known to be more prevalent in males and Black Americans, the representation of race and sex in sleep surgery studies is unknown. The aim of this systematic review is to assess the race and sex demographics represented in sleep surgery studies relative to known OSA demographics. Data Sources PubMed, MEDLINE, and OVID databases. Review Methods A systematic review was conducted to identify studies published between 2016 and 2020 that investigated sleep outcomes following nonnasal surgical intervention for OSA in adults. Pooled racial, ethnic, and sex data of the enrolled subjects in selected studies were analyzed. Results The 148 included studies comprised 13,078 patients. Of the 137 studies that reported sex, 84.0% of participants were male, exceeding the population prevalence of OSA in males, which is estimated at 66%. Only 13 studies reported racial/ethnic demographic data. Of these, 87.8% of patients were White. Out of 30 studies of primarily American patients, only 4 reported race demographic data, with an average of 82.8% White participants. Conclusion There is a racial/ethnic and sex inclusion bias among sleep surgery studies. Future studies should better document the demographics of enrolled participants as well as recruit participants who better represent the demographics of adults with OSA in the general population.

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“…Except for prolonged pain and accepted intraoperative bleeding that can be controlled with bipolar cautery, we do not report any major complications, such as airway embarrassment or wound infection. Similarly, Mure et al [ 16 ] reported no major operative or postoperative complications after surgical excision of LTH using a diode laser or coblation. Due to the study’s small sample size and retrospective design, as well as the fact that all the study participants were selected primarily on the basis of clinical findings, the authors recommend the following prospective design to be used in future studies: a larger sample size; case selection based on the characteristic of obstructive evidence from drug-induced sleep endoscopy, confirming the diagnosis of LTH as an obstructing cause; and long-term evaluation of the quality of life following various surgical modalities of treatment of LTH associated with OSA.…”

Section: Discussionmentioning

confidence: 97%

“…Correlated changes in these indices have been associated with the severity of obstructive sleep apnea. A direct relationship between the severity of obstructive sleep apnea and the AHI and SpO2 parameters, including the desaturation index, was observed in a retrospective study that used data from an obstructive sleep apnea survey that was conducted among the middle-aged Saudi population, which may suggest their potential as predictors of the severity of obstructive sleep apnea [ 16 ]. Different surgical modalities were reported to be used for the resection of lingual tonsil hypertrophy, including cauterization, surgical cold knife, LASER, coblation tongue base reduction, and cryosurgery, with variable degrees of intraoperative and postoperative complications, including bleeding, postoperative infection, pain, and compromised airways.…”

Section: Discussionmentioning

confidence: 99%

Variations in Polysomnographic Indices of Obstructive Sleep Apnea following Lingual Tonsil Hypertrophy Excision: Is the Difference Significant?

et al. 2022

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Background and Objectives: Obstructive sleep apnea (OSA) is a sleep-related respiratory disorder that affects between 5% and 20% of the population. In obstructive sleep apnea, lingual tonsillar hypertrophy (LTH) has been suggested as a contributing factor to airway blockage. Objectives: The aim of this work is to demonstrate the polysomnographic indices and their values in OSA patients with LTH before and after the surgical intervention. Materials and Methods: The study was conducted on eighteen patients endoscopically diagnosed as having LTH, with the main complaints being snoring, sleep apnea, and/or sleep disturbance. Clinical examination, grading of LTH, body mass index (BMI), endoscopic assessment using Muller’s maneuver, and sleep endoscopy were recorded for all patients. The Epworth Sleepiness Scale (ESS) and overnight sleep polysomnography (PSG) were conducted before and after the surgical removal of LTH. All data were submitted for statistical analysis. Results: The mean ± SD of the AHI decreased from 33.89 ± 26.8 to 20.9 ± 19.14 postoperatively, and this decrease was of insignificant statistical value. The average SpO2 (%) mean ± SD was 91.14 ± 5.96, while the mean ± SD of the desaturation index was 34.64 ± 34.2. Following surgery, these indices changed to 96.5 ± 1.47 and 9.36 ± 7.58, respectively. The mean ± SD of the ESS was changed after the surgery, from 17.27 ± 6.48 to 7.16 ± 3.56. The mean ± SD of sleep efficacy was 71.2 ± 16.8 and the snoring index mean ± SD was 277.6 ± 192.37, and both improved postoperatively, to become 88.17 ± 9.1 and 62.167 ± 40.01, respectively. Conclusions: The AHI after lingual tonsillectomy showed no statistically significant change. The changes in the average SpO2 (%), desaturation index, sleep efficiency, snoring index, and Epworth Sleepiness Scale following the surgery were statistically significant.

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Surgical ablation of lingual tonsils in the treatment of obstructive sleep apnea

Cited by 13 publications

References 28 publications

Snoring and Sleep-Related Symptoms: A Novel Non-Invasive 808 nm Wavelength Diode Laser Non-Ablative Outpatient Treatment. A Prospective Pilot-Study on 45 Patients

Snoring and Sleep-Related Symptoms: A Novel Non-Invasive 808 nm Wavelength Diode Laser Non-Ablative Outpatient Treatment. A Prospective Pilot-Study on 45 Patients

Representation of Race and Sex in Sleep Surgery Studies

Variations in Polysomnographic Indices of Obstructive Sleep Apnea following Lingual Tonsil Hypertrophy Excision: Is the Difference Significant?

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