Abstract
The morphology of upper-airway structures plays a major role in the pathogenesis and treatment of obstructive sleep apnea (OSA). Although continuous positive airway pressure (CPAP) is still considered “gold standard” in OSA management, however, patients with epiglottic collapse often cannot tolerate it resulting in poor CPAP compliance and require alternate treatment such as surgery. Even the results of OSA surgery are compromised if there is failure to recognize and treat epiglottic collapse along with tongue base collapse. The prevalence of epiglottis collapse, which was estimated to be around 12% in OSAS patients, is now estimated much higher because of introduction of drug-induced sedation endoscopy (DISE), which helps immensely in the diagnosis of epiglottic collapse. Tongue base reduction surgery with coblation for secondary epiglottic collapse is a successful surgical treatment option for patients with OSA. The epiglottic collapse has to be addressed according to the type and pattern of collapse along with the tongue base. In this chapter, we have discussed the relevant surgical anatomy of tongue base, patient selection, technical requirements, and surgical techniques to address secondary epiglottic collapse along with tongue base surgery, potential life threatening complications such as oedema and bleeding into the airway and their prevention.
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Agrawal, V., Krishnan, V., Kishore, S. (2023). Tongue Base Surgery. In: Delakorda, M., de Vries, N. (eds) The Role of Epiglottis in Obstructive Sleep Apnea. Springer, Cham. https://doi.org/10.1007/978-3-031-34992-8_23
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DOI: https://doi.org/10.1007/978-3-031-34992-8_23
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