Transoral Robotic Surgery for Sleep Apnea

2014 ◽  
pp. 53-60
Author(s):  
Claudio Vicini ◽  
Filippo Montevecchi ◽  
Mohamed Eesa ◽  
Iacopo Dallan
Keyword(s):  
Sleep Apnea ◽  
Robotic Surgery ◽  
Transoral Robotic Surgery

scholarly journals 0659 A Safe and Precise Tongue Base Surgery for Obstructive Sleep Apnea: Real-Time Intraoperative Ultrasound-Assisted Transoral Robotic Surgery

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A251-A252
Author(s):  
C Lin ◽  
C Chang ◽  
J Hsiao ◽  
J Wu ◽  
H Tsai
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Robotic Surgery ◽  
Intraoperative Ultrasound ◽  
Transoral Robotic Surgery ◽  
Tongue Base ◽  
Assessment Tools ◽  
Bleeding Complications ◽  
Lingual Artery ◽  
Obstructive Sleep

Abstract Introduction Lingual artery (LA) injury is a devastating complication of tongue base surgery. Compared with the anatomic findings of computed tomography angiography (CTA), intraoperative blade of mouth gag might change the thickness of base of tongue (BOT) and anatomy of LA. We aimed to investigate the position of LA in the BOT with intraoperative ultrasound (IOU) imaging during transoral robotic surgery (TORS), and evaluate the bleeding complications when assisted with / without IOU. Methods Adult obstructive sleep apnea (OSA) patients who received TORS in BOT resection were recruited since 2016. Assessment tools were pre-op over-night hospital polysomnography (PSG) and anatomy-based Friedman Staging System. Ultrasound imaging was utilized to identify anatomic parameters of LA in BOT, including distance to midline, arterial depth and diameter. Results Ninety-three OSA patients (82 male, 88.2%) were analyzed. The mean age was 42.2±10.0 years old and body mass index was 29.2±4.5 kg/m2. The average apnea hypopnea index (AHI) was 58.1±21.4 events/hour. There were 66 (71.0%), 24 (25.8%) and 3 (3.2%) patients in Friedman stages II, III and IV, respectively. Seventy patients underwent TORS with IOU had shorter operation time (191.7±3.8 minutes) than 23 patients without IOU (220.1±6.6 minutes), less total blood loss (11.3±10.8 versus 19.6±26.7 ml), and more BOT tissue reduction volume (7.1±2.5 versus 3.9±1.6 ml). Significant predictors of arterial depth were higher AHI level during rapid-eye-movement (REM) sleep stage (p=0.038), bigger tonsil size (p=0.034) and more elevated Friedman tongue position (p=0.012). Postoperative complication associated with LA injury was not found in the patients with use of IOU. Conclusion When tongue retracted with blade, the distance to midline and depth of LA were altered in BOT. With IOU assisted, surgeon could identify LA position confidently. It is expectable to maximize efficiency and minimize catastrophic bleeding complications when OSA patients received TORS in BOT resection. Support nil

Transoral robotic surgery for the management of obstructive sleep apnea: a systematic review and meta-analysis

2016 ◽  
Vol 274 (2) ◽  
pp. 647-653 ◽  
Author(s):  
Giuseppe Meccariello ◽  
Giovanni Cammaroto ◽  
Filippo Montevecchi ◽  
Paut T. Hoff ◽  
Matthew E. Spector ◽  
...  
Keyword(s):  
Systematic Review ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Robotic Surgery ◽  
Meta Analysis ◽  
Transoral Robotic Surgery ◽  
Obstructive Sleep

Transoral Robotic Surgery for Obstructive Sleep Apnea

2017 ◽  
Vol 3 (3) ◽  
pp. 122-127 ◽  
Author(s):  
Ahmad F. Mahmoud ◽  
Erica R. Thaler
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Robotic Surgery ◽  
Transoral Robotic Surgery ◽  
Obstructive Sleep
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