The effectiveness of modified tongue base suspension surgery in patients with obstructive sleep apnea

ABSTRACT The Effectiveness of Modified Tongue Base Suspension Surgery in Patients with Obstructive Sleep Apnea Purpose: To investigate the effectiveness of modified tongue base suspension surgery in patients with obstructive sleep apnea. Method: Characteristic and demographic features, preoperative and postoperative polysomnographic values and physical examinations of patients with obstructive sleep apnea at Akdeniz University Faculty of Medicine, Department of Ear, Nose and Throat and Head and Neck Surgery, from 2009 to May 2019, were collected. Results: The preoperative and long-term postoperative polysomnographic data of patients were analyzed. When comparing the long-term postoperative and preoperative polysomnographic tests, statistically significant differences were found in the Epworth Sleepiness Scale, sleep latency, NREM stage I sleep percentage, NREM stage II sleep percentage, NREM stage III sleep percentage, REM percentage, AHIsupine, AHIREM, arousal index, number of REM obstructive apnea, number of NREM obstructive apnea, total apnea duration, longest apnea duration, total apnea index, REM AI, NREM AI, mean mixed apnea duration, NREM hypopnea count, total hypopnea index, REM hypopnea index, NREM hypopnea index, lowest O2 saturation percentage, ODI, and ST90 compared to the preoperative period. 124 patients, 70 of them (56.4%) met the surgical success criteria. Independent two-sample t-test analysis to determine the factors predicting surgical success revealed that REM percentage, AHI, AHISUPIN, AHINREM, arousal index, number of obstructive apneas in REM stage, number of obstructive apneas in NREM stage, total apnea duration, total apnea index, NREM AI, mean mixed apnea duration, mixed apnea in REM stage, lowest O2 saturation percentage, average O2 desaturation percentage, ODI, and ST90 were found to be statistically significant. Conclusion: OSA (Obstructive Sleep Apnea) is a highly complex and heterogeneous disease. With better understanding of its pathophysiology and advancements in diagnostic methods, it has been recognized that obstructions in the tongue base region are significantly relevant. When obstruction related to glossopotosis is observed, modified tongue base suspension surgery stands out compared to classical tongue base suspension surgery in terms of fewer complications, applicability, and cost-effectiveness. The results regarding the long-term effectiveness of modified tongue base suspension surgery are of great significance in the literature. Key Words: Obstructive Sleep Apnea, Tongue Base Suspension, Polysomnography