Surgical outcomes of overlapping lateral pharyngoplasty with or without coblator tongue base resection for obstructive sleep apnea

Abstract

Purpose

Considerable number of patients with obstructive sleep apnea (OSA) failed to respond to positive airway pressure therapy and so turned to surgical procedures. A wide variety of surgical procedures have been developed and advanced, according to obstruction and target site through nasal cavity to trachea. We introduced our overlapping lateral pharyngoplasty (OLP) technique as a surgical option for OSA and evaluated its surgical outcomes both with and without endoscope-guided coblator tongue base resection (CobTBR).

Methods

Sixty-five patients underwent either OLP alone or OLP combined with CobTBR to treat OSA at academic tertiary center. Twenty-nine patients underwent postoperative polysomnography and were divided into two groups, as an OLP group and an OLP combined CobTBR group. Various parameters from physical examinations and polysomnographic results were compared and analyzed.

Results

Most enrolled patients improved on various polysomnographic parameters, including AHI and oxygen levels. In the OLP group, 91.7% of patients showed a surgical response and the overall success rate was 66.7%. Mean AHI improved significantly from 36.3 to 14.8. In the OLP + CobTBR group, all patients showed improvement in AHI and the surgical response rate was 100%. The overall success rate was 70.6% and mean AHI improved from 38.8 to 13.1. In both groups, various parameters such as RDI, lowest O2 saturation, mean O2 saturation, oxygen desaturation index, supine AHI, and ESS significantly improved after surgery.

Conclusion

Our OLP technique appears to be safe and effective among OSA patients. Multi-level OLP surgery combined with CobTBR can be a good surgical strategy for patients experiencing retroglossal obstruction.

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Funding

This research was also supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (2015R1D1A1A02062156).

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Correspondence to Hyung-Ju Cho.

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There are no financial or personal conflicts of interest to declare.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Park, DY., Chung, H.J., Park, S.C. et al. Surgical outcomes of overlapping lateral pharyngoplasty with or without coblator tongue base resection for obstructive sleep apnea. Eur Arch Otorhinolaryngol 275, 1189–1196 (2018). https://doi.org/10.1007/s00405-018-4940-5

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Keywords

  • Obstructive sleep apnea
  • Lateral pharyngoplasty
  • Tongue base resection
  • Surgical outcomes