Transoral robotic surgery for sleep apnea in children: Is it effective?

Thottam, Prasad John; Govil, Nandini; Duvvuri, Umamaheswar; Mehta, Deepak

doi:10.1016/j.ijporl.2015.10.010

Cited by 37 publications

(76 citation statements)

References 16 publications

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“…Many early reports have appropriately focused on safety, feasibility, operative time, and docking time . Pediatric TORS is a clear example of early development and exploration phases of surgical innovation in both its application in the pediatric airway and description in the literature . In attempts to have more evidence‐based innovation, adopting the IDEAL model, as described by McCulloch, is helpful and recommended .…”

Section: Discussionmentioning

confidence: 99%

Transoral robotic surgery for upper airway pathology in the pediatric population

et al. 2016

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Section: Discussionmentioning

confidence: 99%

Transoral robotic surgery for upper airway pathology in the pediatric population

et al. 2016

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“…Trans‐oral robotic surgery (TORS) provides a complete 3‐dimensional endoscopic view, improves exposure and allows for more complete resection through finer dissection with small robotic instrumentation. Thottam et al published a retrospective case series on TORS for the treatment of tongue base obstruction and lingual tonsillar hypertrophy in non‐syndromic and syndromic children (i.e., Down or Noonan syndrome) with persistent OSAS after AT and CPAP failure. Tongue base obstruction and lingual tonsillar hypertrophy were identified by DISE as the only area for airway obstruction.…”

Section: Site‐specific Treatment: Orthodontics and Upper Airway Surgerymentioning

confidence: 99%

Adenotonsillectomy to treat obstructive sleep apnea: Is it enough?

Boudewyns

Abel

Alexopoulos

et al. 2017

Pediatric Pulmonology

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Although adenotonsillectomy is the first line treatment for children with obstructive sleep apnea syndrome (0SAS), improvement in objectively documented outcomes is often inadequate and a substantial number of children have residual disease. Early recognition and treatment of children with persistent OSAS is required to prevent long-term morbidity. The management of these children is frequently complex and a multidisciplinary approach is required as most of them have additional risk factors for OSAS and comorbidities. In this paper, we first provide an overview of children at risk for persistent disease following adenotonsillectomy. Thereafter, we discuss different diagnostic modalities to evaluate the sites of persistent upper airway obstruction and the currently available treatment options. Pediatr Pulmonol. 2017;52:699-709. © 2016 Wiley Periodicals, Inc.

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“…The primary outcome of interest, reported in all 5 studies, was AHI. 17,19-22 The retrospective case series by Abdel-Aziz et al 20 reports the mean pre- and postoperative AHI and minSaO 2 . However, no standard deviation is reported, and no individual data were available despite contacting the senior author.…”

Section: Resultsmentioning

confidence: 99%

“…Qualitatively, all studies demonstrate a reduction in AHI and an increase in minSaO 2 postoperatively. Three studies performed statistical analysis revealing a significant reduction in AHI after LT. 19,21,22 Successful surgery, as defined by AHI <5 postoperatively, was achieved in only 60 of 116 (52%) of patients.…”

Section: Resultsmentioning

confidence: 99%

Lingual Tonsillectomy for Pediatric Persistent Obstructive Sleep Apnea: A Systematic Review and Meta‐analysis

Rivero

Durr

2017

Otolaryngol.--head neck surg.

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Objective To determine the role of lingual tonsillectomy (LT) in pediatric patients with persistent obstructive sleep apnea (OSA) after tonsillectomy and adenoidectomy (T&A). Data Sources PubMed, OVID-MEDLINE, and Cochrane Central from 2006 to 2017. Review Methods Inclusion criteria included English-language studies containing original data on LT in pediatric patients with persistent OSA. Exclusion criteria included case reports and studies without outcome measures. Two investigators independently reviewed all manuscripts and performed quality assessment using validated tools. Meta-analysis was performed. Results Of the 866 abstracts identified, 5 studies met inclusion criteria. All studies were case series (level of evidence 4). Outcome measures included apnea-hypopnea index (AHI), minimum oxygen saturation (minSaO), comorbidity status, and adverse events. Qualitatively, all studies demonstrated reduction in AHI and increase in minSaO after LT. Comorbidities may not affect the success of LT for lingual tonsil hypertrophy (LTH). LT had similar adverse event rates as T&A. Meta-analysis was performed on 4 studies. LT showed a mean change in reduction of AHI and increase of minSaO of -6.64 (95% CI, -8.63 to -4.65) and 4.17 (95% CI, 1.25-7.08), respectively. The overall success rate, defined as postoperative AHI <5, was 52%. Conclusion LT for LTH can be a safe and effective adjunct surgery for persistent OSA in patients after T&A. LT may reduce AHI and increase minSaO, though complete resolution of OSA is rare. Given the limited number of patients studied, no formal recommendations can be made for the routine use of LT for LTH in persistent pediatric OSA.

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Transoral robotic surgery for sleep apnea in children: Is it effective?

Cited by 37 publications

References 16 publications

Transoral robotic surgery for upper airway pathology in the pediatric population

Transoral robotic surgery for upper airway pathology in the pediatric population

Adenotonsillectomy to treat obstructive sleep apnea: Is it enough?

Lingual Tonsillectomy for Pediatric Persistent Obstructive Sleep Apnea: A Systematic Review and Meta‐analysis

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