Objective:To compare sleep-related outcomes in obstructive sleep apnea hypopnea syndrome (OSAHS) patients following base of tongue resection via robotic surgery and endoscopic midline glossectomy.Methods:This was a re...Objective:To compare sleep-related outcomes in obstructive sleep apnea hypopnea syndrome (OSAHS) patients following base of tongue resection via robotic surgery and endoscopic midline glossectomy.Methods:This was a retrospective study.A total of 114 robotic and 37 endoscopic midline glossectomy surgeries were performed between July 2010 and April 2015 as part of single or multilevel surgery.Patients were excluded for indications other than sleep apnea or if complete sleep studies were not obtained.Thus,45 robotic and 16 endoscopic surgeries were included in the analysis.Results:In the robotic surgery group there were statistically significant improvements in AHI [(44.4 ± 22.6) events/h-(14.0 ± 3.0) events/h,P ＜ 0.001] Epworth Sleepiness Scale (12.3 ± 4.6 to 4.5 ± 2.9,P ＜ 0.001),and O2 nadir (82.0％ ± 6.1％ to 85.0％ ± 5.4％,P ＜ 0.001).In the endoscopic group there were also improvements in AHI (48.7 ± 30.2 to 27.4 ± 31.9,P =0.06),Epworth Sleepiness Scale (12.6 ± 5.5 to 8.3 ± 4.5,P =0.08),and O2 nadir (80.2％ ± 8.6％ to 82.7％ ± 6.5％,P =0.4).Surgical success rate was 75.6％ and 56.3％ in the robotic and endoscopic groups,respectively.Greater volume of tissue removed was predictive of surgical success in the robotic cases (10.3 vs.8.6 ml,P =0.02).Conclusions:Both robotic surgery and endoscopic techniques for tongue base reduction improve objective measures of sleep apnea.Greater success rates may be achieved with robotic surgery compared to traditional methods.展开更多
Objective:The present study is a review of transoral robotic surgery (TORS) for the treatment of obstructive sleep apnea-hypopnea syndrome (OSAHS).Methods:The review presents the experience of the robotic center that ...Objective:The present study is a review of transoral robotic surgery (TORS) for the treatment of obstructive sleep apnea-hypopnea syndrome (OSAHS).Methods:The review presents the experience of the robotic center that developed the technique with regards to patient selection,surgical method,and post-operative care.In addition,the review provides results of a systematic review and meta-analysis of the complications and clinical outcomes of TORS when applied in the management of OSAHS.Results:The rate of success,defined as 50％ reduction of pre-operative AHI and an overall AHI ＜20 events/h,is achieved in up to 76.6％ of patients with a range between 53.8％ and 83.3％.The safety of this approach is reasonable as the main complication (bleeding) affected 4.2％ of patients (range 4.2％-5.3％).However,transient dysphagia (7.2％;range 5％-14％) does compromise the quality of life and must be discussed with patients preoperatively.Conclusions:TORS for the treatment of OSAHS appears to be a promising and safe procedure for patients seeking an alternative to traditional therapy.Appropriate patient selection remains an important consideration for successful implementation of this novel surgical approach requiring further research.展开更多
文摘Objective:To compare sleep-related outcomes in obstructive sleep apnea hypopnea syndrome (OSAHS) patients following base of tongue resection via robotic surgery and endoscopic midline glossectomy.Methods:This was a retrospective study.A total of 114 robotic and 37 endoscopic midline glossectomy surgeries were performed between July 2010 and April 2015 as part of single or multilevel surgery.Patients were excluded for indications other than sleep apnea or if complete sleep studies were not obtained.Thus,45 robotic and 16 endoscopic surgeries were included in the analysis.Results:In the robotic surgery group there were statistically significant improvements in AHI [(44.4 ± 22.6) events/h-(14.0 ± 3.0) events/h,P ＜ 0.001] Epworth Sleepiness Scale (12.3 ± 4.6 to 4.5 ± 2.9,P ＜ 0.001),and O2 nadir (82.0％ ± 6.1％ to 85.0％ ± 5.4％,P ＜ 0.001).In the endoscopic group there were also improvements in AHI (48.7 ± 30.2 to 27.4 ± 31.9,P =0.06),Epworth Sleepiness Scale (12.6 ± 5.5 to 8.3 ± 4.5,P =0.08),and O2 nadir (80.2％ ± 8.6％ to 82.7％ ± 6.5％,P =0.4).Surgical success rate was 75.6％ and 56.3％ in the robotic and endoscopic groups,respectively.Greater volume of tissue removed was predictive of surgical success in the robotic cases (10.3 vs.8.6 ml,P =0.02).Conclusions:Both robotic surgery and endoscopic techniques for tongue base reduction improve objective measures of sleep apnea.Greater success rates may be achieved with robotic surgery compared to traditional methods.
文摘Objective:The present study is a review of transoral robotic surgery (TORS) for the treatment of obstructive sleep apnea-hypopnea syndrome (OSAHS).Methods:The review presents the experience of the robotic center that developed the technique with regards to patient selection,surgical method,and post-operative care.In addition,the review provides results of a systematic review and meta-analysis of the complications and clinical outcomes of TORS when applied in the management of OSAHS.Results:The rate of success,defined as 50％ reduction of pre-operative AHI and an overall AHI ＜20 events/h,is achieved in up to 76.6％ of patients with a range between 53.8％ and 83.3％.The safety of this approach is reasonable as the main complication (bleeding) affected 4.2％ of patients (range 4.2％-5.3％).However,transient dysphagia (7.2％;range 5％-14％) does compromise the quality of life and must be discussed with patients preoperatively.Conclusions:TORS for the treatment of OSAHS appears to be a promising and safe procedure for patients seeking an alternative to traditional therapy.Appropriate patient selection remains an important consideration for successful implementation of this novel surgical approach requiring further research.
