Department of Otolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung, Taiwan.
Department of Audiology and Speech Pathology, Asia University, Taichung, Taiwan.
Sci Rep. 2020 Oct 23;10(1):18163. doi: 10.1038/s41598-020-75215-1.
This study compared the characteristic surgical parameters and clinical effects of transoral robotic surgery (TORS) and other available methods used to alleviate obstructive sleep apnea. Articles on TORS and other surgeries for obstructive sleep apnea were identified in the PubMed and EMBASE databases. Two investigators independently reviewed the articles and classified the data for meta-analysis. The pooled effect sizes of TORS (standardized mean difference; SMD = - 2.38), coblation tongue base resection (CTBR; SMD = - 2.00) and upper airway stimulation (UAS; SMD = - 0.94) revealed significant improvement in the apnea-hypopnea index (AHI; p < 0.05). The lowest O saturation reported was significantly increased following TORS (SMD = 1.43), CTBR (SMD = 0.86) and UAS (SMD = 1.24, p < 0.05). Furthermore, TORS (SMD = - 2.91) and CTBR (SMD = - 1.51, p < 0.05) significantly reduced the Epworth Sleepiness Scale (ESS) score. No significant difference in operation time, success rate, or instances of complication were observed between TORS and the other compared interventions. The use of TORS in obstructive sleep apnea has the same rate of success and failure as other methods of surgical intervention for obstructive sleep apnea with no statistical difference in operation times. The reported clinical effects on the AHI, lowest O saturation, and ESS scores of TORS were similar to those of other surgeries.
这项研究比较了经口机器人手术(TORS)和其他用于缓解阻塞性睡眠呼吸暂停的可用方法的特征性手术参数和临床效果。在 PubMed 和 EMBASE 数据库中确定了关于 TORS 和其他用于阻塞性睡眠呼吸暂停的手术的文章。两名调查员独立审查了文章,并对数据进行了分类以进行荟萃分析。TORS(标准化均数差;SMD=-2.38)、等离子舌骨基底切除术(CTBR;SMD=-2.00)和上气道刺激(UAS;SMD=-0.94)的汇总效应大小表明,呼吸暂停低通气指数(AHI;p<0.05)显著改善。报告的最低血氧饱和度在 TORS(SMD=1.43)、CTBR(SMD=0.86)和 UAS(SMD=1.24,p<0.05)后显著增加。此外,TORS(SMD=-2.91)和 CTBR(SMD=-1.51,p<0.05)显著降低了嗜睡量表(ESS)评分。TORS 与其他比较干预措施之间在手术时间、成功率或并发症发生率方面没有观察到显著差异。TORS 用于阻塞性睡眠呼吸暂停的成功率和失败率与其他阻塞性睡眠呼吸暂停手术干预方法相同,手术时间无统计学差异。TORS 在 AHI、最低血氧饱和度和 ESS 评分方面的报告临床效果与其他手术相似。