Transoral Robotic Surgery (TORS) Versus Non-TORS Tongue Resection for Obstructive Sleep Apnea

Area of Science:

• Surgical Innovation
• Sleep Medicine
• Robotic Surgery

Background:

• Obstructive sleep apnea (OSA) significantly impacts patient health and quality of life.
• Tongue resection is a surgical option for OSA, with transoral robotic surgery (TORS) emerging as a technique.
• Understanding the early adoption and outcomes of TORS for OSA is crucial.

Purpose of the Study:

• To compare transoral robotic surgery (TORS) with non-TORS tongue resection for obstructive sleep apnea (OSA).
• To analyze patient characteristics, concurrent procedures, operative time, hospital stay, and complications.
• To evaluate trends in TORS utilization from 2010 to 2015.

Main Methods:

• Utilized the Nationwide Inpatient Sample (NIS) database for adult patients undergoing TORS or non-TORS tongue resection for OSA.
• Analyzed annual case volumes, prolonged hospital stay (≥3 days), and postoperative complications.
• Employed statistical analyses to determine associations between TORS and outcomes.

Main Results:

• TORS patients had lower rates of concurrent nasal surgery (15% vs. 44%) but similar rates for palatal and overall hypopharyngeal surgery.
• TORS use was associated with increased risk of prolonged hospital stay (33% vs. 25%, P = .045).
• No significant association was found between TORS and postoperative complications.

Conclusions:

• TORS use in tongue resection for OSA during the early adoption period was associated with longer hospital stays.
• TORS did not increase the risk of complications compared to non-TORS procedures.
• This study provides valuable data on the initial phase of TORS implementation for OSA treatment.