Trans-oral robotic surgery versus coblation tongue base reduction for obstructive sleep apnea syndrome

Wei-Che Lan; Wen-Dien Chang; Ming-Hsui Tsai; Yung-An Tsou

doi:10.7717/peerj.7812

Trans-oral robotic surgery versus coblation tongue base reduction for obstructive sleep apnea syndrome

PeerJ. 2019 Oct 2:7:e7812. doi: 10.7717/peerj.7812. eCollection 2019.

Authors

Wei-Che Lan¹, Wen-Dien Chang², Ming-Hsui Tsai^{1

3

4}, Yung-An Tsou^{1

3

4}

Affiliations

¹ Department of Otolaryngology Head and Neck Surgery, China Medical University Hospital, Taichung, Taiwan.
² Department of Sport Performance, National Taiwan University of Sport, Taichung, Taiwan.
³ School of Medicine, China Medical University, Taichung, Taiwan.
⁴ Department of Audiology and Speech-Language Pathology, Asia University, Taichung, Taiwan.

Abstract

Objectives: To compare the efficacy of trans-oral robotic surgery (TORS) with that of coblation assisted tongue base reduction surgery in patients with obstructive sleep apnea syndrome (OSAS).

Subjects and methods: The medical charts were retrospectively reviewed for all OSAS patients admitted to one institution for surgical intervention between 2012 and 2017. We analyzed 33 cases; 16 patients received TORS and 17 received coblation surgery for tongue base reduction. Both groups received concomitant uvulopalatoplasty. Surgical outcomes were evaluated by comparing the initial polysomnography (PSG) parameters with the follow-up PSG data (at least 3 months after the surgery). Epworth sleepiness scale (ESS) and complications were also compared between the 2 groups.

Results: The success rate (≥50% reduction of pre-operative AHI and post-operative AHI <20) in the TORS group and coblation group were 50% and 58%, respectively, and there was no significant difference (p = .611). The AHI (mean ± SD) reduction in the TORS and coblation groups were 24.9 ± 26.5 events/h and 19.4 ± 24.8 events/h, respectively; the between-group difference was not significant (p = .631). ESS improvement did not differ significantly between the TORS and coblation groups (3.8 ± 6.6 and 3.1 ± 9.2, respectively, p = .873). The rates of minor complication were higher in the TORS group (50%) than that of the coblation group (35.3%) without statistical significance (p = .393).

Conclusion: TORS achieved comparable surgical outcomes compared to coblation assisted tongue base reduction surgery in OSAS patients. Multilevel surgery using either TORS or coblation tongue base reduction combined with uvulopalatoplasty is an effective approach for the management of OSAS.

Keywords: Coblation; Obstructive sleep apnea syndrome; TORS; Tongue base; Trans-oral robotic surgery.

Grants and funding

This work was supported by China Medical University (No. CMU-102-bc3 and DMR-107-040). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.