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

Area of Science:

• Otolaryngology
• Sleep Medicine
• Surgical Innovation

Background:

• Obstructive sleep apnoea (OSA) significantly impacts patient quality of life.
• Tongue base surgery is a key intervention for OSA management.
• Comparing surgical approaches is crucial for optimizing patient outcomes.

Purpose of the Study:

• To evaluate the effectiveness of transoral robotic surgery (TORS) versus coblation for tongue base reduction in OSA patients.
• To compare the complication rates associated with TORS and coblation.
• To assess the impact of these procedures on the Apnoea-Hypopnea Index (AHI) and Epworth Sleepiness Score (ESS).

Main Methods:

• Prospective analysis of 85 patients with OSA undergoing either TORS (37 patients) or coblation (33 patients).
• Primary outcome measure: Apnoea-Hypopnea Index (AHI) reduction.
• Secondary outcome measures: Epworth Sleepiness Score (ESS), Muller's manoeuvre, polysomnography, and complication rates.
• Follow-up at 6 months post-surgery.

Main Results:

• Both TORS and coblation significantly reduced AHI (TORS: 29.7 to 10.7; Coblation: 27.2 to 10.3).
• Success rates (50% AHI reduction, AHI < 20) were similar: 75.6% for TORS and 78.7% for coblation.
• ESS scores improved significantly in both groups.
• TORS demonstrated higher complication rates compared to coblation.

Conclusions:

• TORS and coblation are promising treatments for OSA, yielding comparable improvements in AHI.
• Coblation is associated with lower complication rates than TORS.
• Patient selection should consider the trade-off between efficacy and morbidity for tongue base surgery.