Combined transoral robotic tongue base surgery and palate surgery in obstructive sleep apnea-hypopnea syndrome: expansion sphincter pharyngoplasty versus uvulopalatopharyngoplasty

Head Neck. 2014 Jan;36(1):77-83. doi: 10.1002/hed.23271. Epub 2013 Jun 14.

Abstract

Background: Transoral robotic surgery (TORS) for obstructive sleep apnea-hypopnea syndrome is a relatively young technique principally devised for managing apneas in the tongue base (TB) area and supraglottic larynx. This procedure is included in the so-called "multilevel surgery" often including a palatal and nasal surgery.

Methods: We carried out a retrospective analysis in order to understand in detail the relative impact on apneas of the 2 different procedures carried out in the palate area (expansion sphincter pharyngoplasty and uvulopalatopharyngoplasty). We evaluated 2 groups, each of 12 cases, which were sorted according to the primary selection criteria of statistically comparable preoperative apnea-hypopnea index (AHI), sex, age, body mass index (BMI), and volume of removed TB tissue.

Results: Postoperative AHI registered was of 9.9 ± 8.6 SD for the expansion sphincter pharyngoplasty group and 19.8 ± 14.1 SD for the uvulopalatopharyngoplasty group.

Conclusion: As the palate component of our multilevel procedure, expansion sphincter pharyngoplasty, including conventional nose surgery and robotic surgery, seems to be superior to uvulopalatopharyngoplasty.

Keywords: obstructive sleep apnea hypopnea syndrome; palate surgery; robotic surgery; sleep apnea; tongue base.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Cohort Studies
  • Combined Modality Therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods
  • Oral Surgical Procedures / methods
  • Otorhinolaryngologic Surgical Procedures / methods*
  • Pharynx / surgery*
  • Retrospective Studies
  • Risk Assessment
  • Robotics / methods*
  • Sleep Apnea Syndromes / diagnosis
  • Sleep Apnea Syndromes / surgery*
  • Statistics, Nonparametric
  • Tongue / surgery
  • Treatment Outcome
  • Uvula / surgery*