Baptista Peter M, Diaz Zufiaurre Natalia, Garaycochea Octavio, Alcalde Navarrete Juan Manuel, Moffa Antonio, Giorgi Lucrezia, Casale Manuele, O'Connor-Reina Carlos, Plaza Guillermo
Department of Otorhinolaryngology, Clinica Universidad de Navarra, Av. de Pío XII, 36, 31008 Pamplona, Spain.
School of Medicine, Campus Bio-Medico University, Via Alvaro del Portillo 21, 00128 Rome, Italy.
J Clin Med. 2022 Feb 14;11(4):990. doi: 10.3390/jcm11040990.
Transoral robotic surgery (TORS) for Obstructive Sleep Apnea (OSA) is a relatively young technique principally devised for managing apneas in the tongue base area. This study summarizes and presents our personal experience with TORS for OSA treatment, with the aim to provide information regarding its safety, efficacy, and postoperative complications. A retrospective study was conducted on patients undergoing TORS with lingual tonsillectomy through the Da Vinci robot. The effectiveness of the surgical procedure was assessed employing the Epworth Sleepiness Scale (ESS) and overnight polysomnography with the Apnea-Hypopnea Index (AHI). A total of 57 patients were included. Eighteen patients (31.6%) had undergone previous surgery. The mean time of TORS procedure was 30 min. Base of tongue (BOT) management was associated with other procedures in all patients: pharyngoplasty (94%), tonsillectomy (66%), and septoplasty (58%). At 6 months follow-up visit, there was a significant improvement in AHI values (from 38.62 ± 20.36 to 24.33 ± 19.68) and ESS values (from 14.25 ± 3.97 to 8.25 ± 3.3). The surgical success rate was achieved in 35.5% of patients. The most frequent major complication was bleeding, with the need for operative intervention in three cases (5.3%). The most common minor complications were mild dehydration and pain. TORS for OSA treatment appears to be an effective and safe procedure for adequately selected patients looking for an alternative therapy to CPAP.
经口机器人手术（TORS）治疗阻塞性睡眠呼吸暂停（OSA）是一项相对较新的技术，主要用于处理舌根区域的呼吸暂停。本研究总结并介绍了我们使用TORS治疗OSA的个人经验，旨在提供有关其安全性、有效性和术后并发症的信息。对通过达芬奇机器人进行舌根扁桃体切除术的TORS患者进行了一项回顾性研究。采用Epworth嗜睡量表（ESS）和夜间多导睡眠图及呼吸暂停低通气指数（AHI）评估手术效果。共纳入57例患者。18例患者（31.6%）曾接受过手术。TORS手术的平均时间为30分钟。所有患者的舌根（BOT）处理均与其他手术相关：咽成形术（94%）、扁桃体切除术（66%）和鼻中隔成形术（58%）。在6个月的随访中，AHI值（从38.62±20.36降至24.33±19.68）和ESS值（从14.25±3.97降至8.25±3.3）有显著改善。35.5%的患者实现了手术成功率。最常见的主要并发症是出血，3例（5.3%）需要手术干预。最常见的轻微并发症是轻度脱水和疼痛。对于寻求CPAP替代疗法的合适患者，TORS治疗OSA似乎是一种有效且安全的手术。
