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05:25
Identification and Protection of the Recurrent Laryngeal Nerve during Transoral Robotic Thyroidectomy
Published on: October 24, 2025
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Transoral Robotic Lingual Tonsillectomy for Pediatric Obstructive Sleep Apnea.
Daniel J Campbell1, Daron Excel2, W Jack Palmer1
1Department of Otolaryngology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
The Laryngoscope
|November 27, 2025
Summary
Transoral robotic surgery (TORS) lingual tonsillectomy (LT) is a safe and effective treatment for pediatric obstructive sleep apnea (OSA). This study shows significant improvements in sleep apnea metrics following TORS LT.
Area of Science:
- Otolaryngology
- Robotic Surgery
- Pediatric Sleep Medicine
Background:
- Obstructive sleep apnea (OSA) in children is often caused by lingual tonsillar hypertrophy.
- Traditional surgical approaches for lingual tonsillectomy (LT) may have limitations in visualization and precision.
Purpose of the Study:
- To evaluate the safety and efficacy of transoral robotic surgery (TORS) for lingual tonsillectomy (LT) in pediatric patients with OSA.
- To compare TORS LT with and without epiglottopexy to non-robotic methods.
Main Methods:
- A retrospective chart review of 56 pediatric patients who underwent TORS LT between 2015 and 2024.
- Analysis of pre- and postoperative polysomnogram data, clinical, and demographic information.
- Assessment of surgical success predictors and complication rates.
Main Results:
- 60.5% of patients achieved surgical success, with significant reductions in apnea-hypopnea index and improvements in oxygen saturation.
- No significant differences in success rates were observed based on OSA severity, syndromic status, or obesity.
- Complications included postoperative hemorrhage (8.9%) and oropharyngeal scarring (3.6%).
Conclusions:
- TORS LT is a safe and effective surgical option for pediatric OSA patients with lingual tonsillar hypertrophy.
- Benefits include enhanced 3D visualization and improved dissection of the lingual tonsil.
- Larger studies are needed to further explore sleep and quality of life outcomes.
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