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

Abstract

We investigated safety and efficacy of transoral robotic surgery (TORS) for base of tongue (BOT) reduction in obstructive sleep apnea syndrome (OSAS) patients. PubMed, Cochrane Library, and Scopus were searched. A meta‐analysis was performed. Random effects models were used. Thirty‐one cohorts met our criteria (1693 patients). The analysis was based mostly on retrospective studies. The summary estimate of the reduction of Apnea–Hypoxia Index (AHI) was 24.25 abnormal events per hour (95% CI: 21.69–26.81) and reduction of Epworth Sleepiness Scale (ESS) was 7.92 (95% CI: 6.50–9.34). The summary estimate of increase in lowest O2 saturation was 6.04% (95% CI: 3.05–9.03). The success rate of TORS BOT reduction, either alone or combined with other procedures, was 69% (95% CI: 64–79). The majority of studies reported low level of evidence but suggested that TORS BOT reduction may be a safe procedure associated with improvement of AHI, ESS, and lowest O2 saturation.

Combined Transoral Robotic Tongue Base Surgery and Palate Surgery in Obstructive Sleep Apnea Syndrome: Modified Uvulopalatopharyngoplasty versus Barbed Reposition Pharyngoplasty

“…The incidences of OSA syndrome have increased threefold in the last 20 years [ 29 ]. Single-level surgery had a limited number of successful surgical results in the last two decades [ 29 ].…”

“…The incidences of OSA syndrome have increased threefold in the last 20 years [ 29 ]. Single-level surgery had a limited number of successful surgical results in the last two decades [ 29 ]. UPPP with or without tonsillectomy could not only improve the respiratory events during night sleep but also improve sleep quality, depression, sexual function, ventricular function, and promote safe driving in OSA patients [ 30 ].…”

A Review of a Recent Meta-Analysis Study on Obstructive Sleep Apnea

“…A meta-analysis on 31 of these studies (1,693 patients) found a 24.3 decline in the AHI (95% CI: 21.69-26.81), a 7.92 decline in ESS (95% CI: 6.50-9.34), a 6.04% increase in the lowest oxygen saturation (95% CI: 3.05-9.03), and 69% in a surgery success rate (95% CI: 64-79). However, these findings provide low evidence for proving the effectiveness of the robot surgeries, because most of the robot surgeries were performed along with soft palate surgeries and the studies did not include any control group [50].…”

Patienten-Benefit und Lebensqualität nach Roboter-assistierten Operationen im Kopf-Hals-Bereich

“…Eine aktuelle Meta-Analyse von 31 Studien zeigt ein erfolgsversprechendes Therapieansprechen nach o.g. Kriterien von 69 % nach TORS bei ausgewählten OSAS-Patienten [198]. Während nach TORS-Eingriffen bei OSAS-Patienten keine schwerwiegenden Komplikationen bekannt sind, ist zu beachten, dass die Eingriffe am Zungengrund zu Einschränkungen des Schluckvermögens führen können.…”