Transoral Robotic Surgery as Single Level Surgery for Treatment of Obstructive Sleep Apnea

Chapter

Abstract

Obstructive sleep apnea/hypopnea syndrome (OSAHS) is a disease entity that may involve multiple levels of the upper airway from the level of nose down to glottis. The recognition of the important contribution of base of tongue (BOT) obstruction to OSAHS led to the development of multiple surgical techniques and approaches directed at the BOT level. Transoral robotic surgery (TORS)-assisted BOT reduction is one such technique, first reported by Vicini. Although TORS-assisted BOT reduction is most commonly combined with other upper airway procedures to treat OSAHS, it can potentially be used as a stand-alone surgical modality in properly selected patients. Drug induced sleep endoscopy (DISE) is a valuable diagnostic tool in localizing the site, identifying the pattern, and determining the severity of upper airway obstruction. We have shown that the use of TORS-assisted BOT reduction alone can be effective in reducing apnea hypopnea index (AHI), Epworth sleepiness scale (ESS) score, and snoring intensity in patients with obstruction identified at the BOT level. Complications associated with TORS-assisted BOT reduction included taste disturbance, oropharyngeal stenosis, and bleeding.

Keywords

Drug induced sleep endoscopy (DISE) Obstructive sleep apnea/hypopnea syndrome (OSAHS) Base of tongue (BOT) Transoral robotic surgery (TORS) 

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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Department of Otolaryngology—Head & Neck SurgeryWayne State UniversityDetroitUSA
  2. 2.Department of SurgeryJohn D Dingell VA Medical CenterDetroitUSA

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