The effectiveness of transoral robotic tongue base surgery in patients with obstructive sleep apnea

Purpose: To investigate the effectiveness of transoral robotic tongue base surgery in patients with obstructive sleep apnea. Method: Characteristic and demographic features, preoperative and postoperative polysomnographic values, physical examinations and evaluations under anesthesia of patients with obstructive sleep apnea at Akdeniz University Faculty of Medicine, Department of Ear, Nose and Throat and Head and Neck Surgery, from 2018 to October 2023, were collected. Medical conditions that are contraindicated for surgery and general anesthesia, uncontrolled psychiatric diseases, unrealistic surgical expectations, patients with mouth opening not suitable for robotic surgery, trismus, patients whose postoperative polysomnography test could not be obtained, and patients under the age of 18 were not included in the study. Results: When postoperative and preoperative polysomnographic tests were compared, body mass index, Epworth sleepiness scale, sleep efficiency percentage, NREM stage II sleep, REM percentage, AHI, AHISupine, AHIREM, arousal index, number of REM obstructive apnea, number of NREM obstructive apnea, number of average obstructive apnea. apnea duration, total apnea duration, longest apnea duration, total apnea index, number of REM central apneas, number of NREM central apneas, number of REM hypopneas, number of NREM hypopneas, average hypopnea duration, longest hypopnea duration, total hypopnea index, average O2 saturation percentage, lowest O2 saturation percentage, average O2 desaturation percentage, ODI and ST90 were found to be statistically significantly different in postoperative data compared to the preoperative period. Multivariate regression analysis was performed to find predictive values for surgical success; AHIREM, number of REM obstructive apnea, number of NREM obstructive apnea, mean obstructive apnea duration, total apnea duration, minimum O2 saturation, mean O2 desaturation and ST90 values have come to the fore as predictive values for surgical success. Postoperative side effects and complications were evaluated after the operation, and bleeding in the tonsillar area came first. In the second place is a globus sensation in the throat, and in the third place is oral intake disorder. Conclusion: Transoral robotic tongue base surgery, which is performed to reduce tongue base volume, provides significant benefits in improving the living standards of OSA patients with its rapid learning curve and practical applicability. The predictive values used to predict the success of TORS, which is a relatively new approach compared to other surgical methods, need to be increased and finalized, and the success criteria need to be re-evaluated. Key Words: Obstructive Sleep Apnea, Tongue Base Resection, Robotic Surgery, Polysomnography