Investigation of the Effectiveness of Surgical Treatment on Respiratory Functions in Patients With Obstructive Sleep Apnea Syndrome

Abstract

Objective: Obstructive sleep apnea syndrome (OSAS) is a problem that involves many bodily systems and its effects on the respiratory system deserve special attention. Although many studies exist that investigate respiratory functions in patients using continuous positive airway pressure (CPAP) for the treatment of sleep apnea, there is a lack of research regarding the effect of OSAS surgery on respiratory function in the literature, which has motivated us to perform such a study. Materials and Methods: Thirty-two patients diagnosed with OSAS with an apnea hypopnea index ranging between 15 and 30 and had undergone robotic tongue base resection and uvulopharyngoplasty were included as study participants. Pulmonary function tests were performed on all participants 1 day prior to, and at 3 and 6 months after the operation. Weight and body mass indices (BMIs) were also recorded at the same intervals for all participants. Data were electronically recorded and analyzed through SPSS 22.0. Values of P < .05 have been considered as statistically significant. Results: Average age of the 32 participants was 43.2±10.7, average body weight was 94.1±12.6, and average BMI was 31.4±4.7. Decreases in body weight and BMI values recorded at 3 and 6 months postoperatively had statistical significance when compared with values recorded preoperatively ( P < .05). Comparisons made in terms of pulmonary functions revealed a statistically significant increase in 3 and 6-month postoperative values of FVC, FEV1, FEV1/FVC, PEF, and FEF 25-75 ( P < .05). Conclusion: Our study shows the positive effects of robotic tongue base resection and uvulopharyngoplasty operation on respiratory function parameters. This suggests that surgical treatment in OSAS patients is as effective as CPAP on respiratory function.

Surgical, clinical, and functional outcomes of transoral robotic surgery used in sleep surgery for obstructive sleep apnea syndrome: A systematic review and meta‐analysis

“…The electronic search identified 140 papers, of which 31 met our inclusion criteria 16‐47 . There were 22 retrospective, 8 prospective uncontrolled studies, and one controlled randomized trial.…”

“…The majority of authors included patients with moderate to severe OSAS using various AHI thresholds 16,19,20,23,26‐33,35,36,39,41‐43,45‐47 . Three authors included patients with mild OSAS 21,22,44 .…”

“…The BOT resection was limited to the lymphoid tissue resection in two studies, 37,46 while the surgery involved both lymphoid tissue and tongue muscle resection at the surgeon's discretion in eight studies 16,18‐20,22,24,25,27,28,30,33‐35,38,41,43,44 . There were no information about the potential excision of tongue muscle in five studies 29,31,39,40,42 . Use of tracheotomy was reported in eight studies, and in these studies the percentage of patients receiving tracheotomy ranged widely from 1% to 100% 19,24,25,31,33,41,43,44 …”

“…Moreover, the assessment of obstruction location through the sleep endoscopy or Müller maneuver was subjective and is heavily operator dependent. Only three studies used a validated scoring system for evaluating the severity of obstruction 25,29,40 …”

“…Overall, the severity of snoring significantly improved at 6 months post‐multilevel surgery 16,17,20,45 . The following sleep/respiratory outcomes were evaluated in some studies: respiratory disturbance index, 20 sleep stage rapid eye movement, 20 percentage of sleep hypoxic time, 20 nocturnal desaturation, 33 forced vital capacity, 29 forced expired volume 1 s, 29 peak expiratory flow, 29 and forced expiratory flow 25–75 29 . In these studies, all of these parameters significantly improved from pretreatment to posttreatment.…”