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. 2025 Mar;282(3):1459-1468.
doi: 10.1007/s00405-024-09102-0. Epub 2024 Dec 9.

Patient centered outcomes of transoral robotic surgery for obstructive sleep apnea: a retrospective analysis

Alexandra G L Toppenberg  1   2 , Wouter L Lodder  3 , Robert E Plaat  3 , Leonora Q Schwandt  3
Affiliations

Patient centered outcomes of transoral robotic surgery for obstructive sleep apnea: a retrospective analysis

Alexandra G L Toppenberg et al. Eur Arch Otorhinolaryngol. 2025 Mar.

Abstract

Purpose: Obstructive Sleep Apnea (OSA) is usually caused by collapse of the base of tongue (BOT) and impacts patients' overall health. Despite current conventional therapies, some patients do not achieve satisfactory results. Reduction of BOT using Trans Oral Robotic Surgery (TORS) emerges as a promising treatment. We evaluated the patient reported and clinical outcomes of TORS for OSA.

Methods: We performed a retrospective cohort study of patients treated from 2018 to 2021 in a non-academic general hospital. Patients were eligible for TORS when apnea hypopnea index (AHI) was >5 in combination with obstruction at BOT level. Patients were included when 1-year follow up respiratory polygraphy was available. Changes in Epworth Sleepiness Scale (ESS), Functional Outcomes of Sleep Questionnaire (FOSQ-35), MD Anderson Dysphagia Inventory (MDADI) scores and postoperative complications were evaluated. Surgical success rates were obtained.

Results: Out of 56 patients, 28 patients of which 22 (78.6%) males and 6 (21.4%) females, with OSA severity ranging from mild to severe and mean age of 49 (SD 11.8) with a median BMI of 28.1 (IQR 26.9-32.1) were included. ESS score declined from mean 5.9 (SD 3.8) to 2.2 (SD 2.0) (p<0.00). FOSQ-35 scores were all declined (p<0.05). MDADI scores were in normal range (80-100) and remained stable (p = 0.44). In 23 (82.1%) patients no postoperative complications were observed. Surgical success rates were 86%.

Conclusions: TORS demonstrate to be effective and safe in OSA patients, and it can be used in both patients who are unresponsive to conventional therapies or as a primary therapy.

Keywords: Base of the Tongue; Lingual Tonsils; Obstructive Sleep Apnea; Trans Oral Robotic Surgery.

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Conflict of interest statement

Declarations. Conflict of interest: All authors declare no financial or non-financial interests that are directly or indirectly related to the work submitted.

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