Robotic Tongue-Base Resection Combined With Tongue-Base Suspension for Obstructive Sleep Apnea

Area of Science:

• Otolaryngology
• Sleep Medicine
• Robotic Surgery

Background:

• Obstructive sleep apnea (OSA) with tongue-base collapse presents a significant clinical challenge.
• Continuous positive airway pressure (CPAP) is often ineffective for patients with tongue-base collapse.

Purpose of the Study:

• To evaluate the feasibility, safety, and efficacy of transoral robotic surgery (TORS) tongue-base resection (TBR) combined with tongue-base suspension (TBS) for OSA.
• To identify factors influencing treatment success.

Main Methods:

• A prospective, single-arm observational cohort study.
• 64 patients with moderate-to-severe OSA and tongue-base collapse underwent TORS-TBR with TBS, with optional concomitant procedures.
• Patients were selected based on apnea-hypopnea index (AHI) and drug-induced sleep endoscopy (DISE) findings.

Main Results:

• The procedure demonstrated a 75% success rate with minor morbidity.
• Significant improvements were observed in AHI (41.7 to 18.8 events/hour) and Epworth Sleepiness Scale scores (10.5 to 4.1).
• Temporary lingual edema was the most common complication; no tracheotomies were required.

Conclusions:

• TORS-TBR combined with TBS is a feasible, safe, and effective surgical option for OSA patients with tongue-base collapse.
• While generally successful, patients with more severe disease may show a reduced response to treatment.