Quantification of the Impact of Intraoperative Ultrasound in Transoral Robotic Tongue Base Reduction

Laryngoscope. 2022 May;132(5):1125-1131. doi: 10.1002/lary.29931. Epub 2021 Oct 29.

Abstract

Objectives/hypothesis: Transoral robotic surgery (TORS) in the base of the tongue (BOT) reduction has been shown to decrease the apnea-hypopnea index (AHI) and improve daytime sleepiness in obstructive sleep apnea (OSA) patients. Intraoperative ultrasound (IOU) can be employed to guide the surgery and prevent massive bleeding.

Study design: Cohort study with historical control.

Methods: A cohort study to compare the outcomes between OSA patients who received TORS with and without IOU assistance.

Results: From 2016 to 2019, this study enrolled 80 OSA patients who underwent TORS in BOT: 57 in the IOU(+) and 23 in IOU(-) groups. The TORS with IOU presented with shorter operative time, less blood loss, and greater excised BOT volume. The IOU(+) group had greater improvement in the AHI and subjective questionnaire evaluation. The excised volume of BOT was significantly associated with the change in AHI.

Conclusion: The IOU could improve outcomes in BOT reduction surgery without raising the risk of surgical complications.

Level of evidence: 4 Laryngoscope, 132:1125-1131, 2022.

Keywords: Obstructive sleep apnea; intraoperative ultrasound; precision surgery; tongue base reduction; transoral robotic surgery.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cohort Studies
  • Hemorrhage
  • Humans
  • Robotic Surgical Procedures*
  • Sleep Apnea, Obstructive* / diagnostic imaging
  • Sleep Apnea, Obstructive* / surgery
  • Tongue / diagnostic imaging
  • Tongue / surgery
  • Treatment Outcome