Polysomnography Outcomes after Transoral Robotic Lingual Tonsillectomy for Obstructive Sleep Apnea

Abstract

Poster Presentations P263and professional life; (2) Motivating factors for choosing surgery; (3) Patient knowledge; (4) Postoperative challenges; (5) Impact of OSA surgery.Conclusions: Patients' experiences going into the surgery can largely influence their perceived outcome and satisfaction. These experiences are individual and subjective, and the postoperative sleep studies do not capture the whole outcome of the patients' response to surgery. This suggests when patient reported outcomes are combined with postoperative sleep studies, otolaryngologists can gain a much better perspective about their patients.Objectives: Compare polysomnography (PSG) results before and after transoral robotic lingual tonsillectomy (TORLT) in patients with obstructive sleep apnea (OSA).Methods: Lingual tonsillar or base of tongue hypertrophy can be a cause of OSA but has proven difficult to address because of difficulty in accessing this area of the oropharynx through traditional surgical techniques. TORLT provides a simple, minimally invasive surgical technique for lingual tonsillectomy. Patients with OSA symptoms were assessed with preoperative PSG and sleep endoscopy for base of tongue obstruction. Selected candidates underwent TORLT followed by repeat PSG and nasal endoscopy after full recovery from the procedure. The pre-and postoperative PSG data were compared for each patient. Nonparametric comparisons were made using the signed rank test becasue of small sample size.Results: Ten patients underwent preoperative PSG and subsequent TORLT. Postoperative polysomnography data as available for 8 patients. Pre-and postoperative PSG comparisons (pre, post, P value) showed improvements in the median apnea-hypopnea index (49.8, 19.5, P = .84), sleep onset latency (11.8 minutes, 17.5 minutes, P = .84), sleep efficiency (80.5%, 92.3%, P = .2), and Epworth Sleepiness Scale (14.5, 10, P = .88), but none were statistically significant.Conclusions: Transoral robotic lingual tonsillectomy improved polysomnography measures but not to a level of significance. This study is limited by small sample size and associated limited statistical power. Further study with larger sample sizes should be undertaken to more definitively study outcomes for this surgical technique. Prevalence of High Risk for Obstructive Sleep Apnea using STOP-Bang Questionnaire in Thai PopulationNatamon Charakorn, MD (presenter); Prakobkiat Hirunwiwatkul; Apasee Suksamran, MD; Busarakum Teerapraipruk, MD; Naricha Chirakalwasan, MD Objectives: Determine the prevalence of high risk for obstructive sleep apnea (OSA) in general Thai population by using the STOP-Bang questionnaire. Methods: Anonymous survey was conducted in Thailand atHealth and Wellness exhibition. The exclusion criterion was age <18 years. The STOP-Bang questionnaire was used in the survey. This questionnaire consisted of 4 simple yes/no questions: snoring, tiredness, observed apneas, blood pressure, and 4 clinical characteristics which were dichotomized according to specified cutoffs; body mass index >35, age >...