Tongue base suspension procedures for obstructive sleep apnea syndrome

Koçdor, Pelin; Froymovich, Oleg; Mickelson, Samuel A.

doi:10.1016/j.otot.2015.08.002

Cited by 3 publications

(2 citation statements)

References 7 publications

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“…A commercial TBS kit (Repose) [ 19 ] was introduced through stabilization of the suture over the inner lower gum using a specially designed screw [ 30 ]. Later, Medtronic acquired the Repose system (Repose Surgical Kit, CKA Air Vance, Medtronic, Inc.) and the entry of the suspension suture was changed to a submental incision [ 31 ]. The Repose system is used worldwide and has become the stereotype for tongue base suspension in OSA despite some individual modifications in the technique [ 20 , 32 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

Transoral Tongue Suspension for Obstructive Sleep Apnea—A Preliminary Study

Hsin

Lee

Lin

et al. 2022

JCM

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Objectives: To evaluate the safety and efficacy of a novel technique for transoral tongue suspension (TOTS) in obstructive sleep apnea (OSA) patients. Material and Methods: The retrospective study enrolled 24 consecutive OSA patients (21 males; average age, 43 years; average apnea–hypopnea index (AHI), 42.2 event/h; average body mass index (BMI), 25.7 kg/m2) with tongue obstruction confirmed by drug-induced sleep endoscopy. All patients received TOTS as the main procedure in conjunction with uvulopalatopharyngoplasty (UPPP). Key procedures of TOTS included a transoral sublabial approach, drilling two holes on the mandible, passing the polypropylene through the hole to the tongue base using a suture passer and returning the polypropylene through loop traction, and tying the polypropylene to the mandible. Lingual tonsil ablation (n = 8) was also implemented in hypertrophic lingual tonsils (grades III and IV). Results: The operation time for TOTS was around 30 min. No wound bleeding or airway compromise occurred throughout the postoperative period. Minor complications were temporary and included swelling of the tongue, numbness of the lower incisor, and sublabial wound dehiscence (n = 2). The quality of life improved significantly in the patients’ subjective daytime sleepiness according to the Epworth Sleepiness Scale (11.4 ± 3.2 vs. 5.7 ± 1.6, p < 0.001). The objective parameters of OSA also improved significantly in the apnea/hypopnea index (42.2 ± 21.8 vs. 19.5 ± 16.2, p < 0.001), minimal oxygen saturation (77.1 ± 12.2 vs. 81.7 ± 8.1, p = 0.026), and snoring index (207 ± 141 vs. 101 ± 91, p = 0.03). Conclusions: The demonstrated TOTS showed its advantage in low morbidity with a scarless exterior and easy performance with free availability in treating adult OSA patients with tongue obstruction. TOTS combined with UPPP significantly improved AHI and daytime sleepiness. TOTS can be implemented with lingual tonsillectomy to achieve both stabilization of the tongue and widening of hypopharyngeal airway.

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Section: Discussionmentioning

confidence: 99%

Transoral Tongue Suspension for Obstructive Sleep Apnea—A Preliminary Study

Hsin

Lee

Lin

et al. 2022

JCM

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“…A standard procedure is carried out using a Repose system (Repose Surgical Kit, CKA Air Vance, Medtronic, Inc.). Through a submental incision, a screw is placed into the mandible, and the tongue is stabilized with a suture using a screw as an anchor [ 127 ]. Hsin et al most recently presented a transoral tongue base suspension (TOTS) method [ 128 ].…”

Section: Surgical Therapy For Obstructive Sleep Apneamentioning

confidence: 99%

Oromaxillofacial Surgery: Both a Treatment and a Possible Cause of Obstructive Sleep Apnea—A Narrative Review

Martinović

Tokic

Puizina-Mladinic

et al. 2023

Life

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Obstructive sleep apnea (OSA) is a chronic, sleep-related breathing disorder. It is characterized by a nocturnal periodic decrease or complete stop in airflow due to partial or total collapse of the oropharyngeal tract. Surgical treatment of OSA is constantly evolving and improving, especially with the implementation of new technologies, and this is needed because of the very heterogeneous reasons for OSA due to the multiple sites of potential airway obstruction. Moreover, all of these surgical methods have advantages and disadvantages; hence, patients should be approached individually, and surgical therapies should be chosen carefully. Furthermore, while it is well-established that oromaxillofacial surgery (OMFS) provides various surgical modalities for treating OSA both in adults and children, a new aspect is emerging regarding the possibility that some of the surgeries from the OMFS domain are also causing OSA. The latest studies are suggesting that surgical treatment in the head and neck region for causes other than OSA could possibly have a major impact on the emergence of newly developed OSA, and this issue is still very scarcely mentioned in the literature. Both oncology, traumatology, and orthognathic surgeries could be potential risk factors for developing OSA. This is an important subject, and this review will focus on both the possibilities of OMFS treatments for OSA and on the OMFS treatments for other causes that could possibly be triggering OSA.

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Novel Therapies in the Treatment of Obstructive Sleep Apnea

Bhattacharya¹,

Chakrabarti²

2015

Indian Journal of Sleep Medicine

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There is an effort on several fronts for newer effective therapy for obstructive sleep apnea. This is because, till now the two main modalities of therapy, continuous positive airway pressure therapy or use of various oral appliances are fraught with problems of poor acceptance and long time adherence. Though numerous modalities have been tried which are discussed in the review, there are few novel approaches which hold great promise as probable effective modalities for the future. In children, the simplest cost effective treatment undoubtedly remains a well timed adeno-tonsillectomy which could as well be curative. However, a high flow open nasal cannula based positive airway pressure therapy has been found to be effective in mild and moderately obese children. In adults, oral pressure therapy using an external suction apparatus connected to an intra oral device, that increases the retropharyngeal space and prevents the tongue from falling back, has been found to be effective in initial studies. Stimulation of the genioglossus by hypoglossal nerve pacing with the use of a pulse generator placed in the infraclavicular region is another promising modality. Various new surgical techniques specially the maxilla mandibular advancement procedures and computerized surgical planning methods hold great promise. Lastly, the multimodality approach using the new knowledge on the pathophysiology of sleep apnea is likely to be the therapy for the future.

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Tongue base suspension procedures for obstructive sleep apnea syndrome

Cited by 3 publications

References 7 publications

Transoral Tongue Suspension for Obstructive Sleep Apnea—A Preliminary Study

Transoral Tongue Suspension for Obstructive Sleep Apnea—A Preliminary Study

Oromaxillofacial Surgery: Both a Treatment and a Possible Cause of Obstructive Sleep Apnea—A Narrative Review

Novel Therapies in the Treatment of Obstructive Sleep Apnea

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