Transoral robotic surgery of the tongue base in obstructive sleep Apnea‐Hypopnea syndrome: Anatomic considerations and clinical experience

Vicini, Claudio; Dallan, Iacopo; Canzi, Pietro; Frassineti, Sabrina; Nacci, Andrea; Seccia, Veronica; Panicucci, Erica; Pietra, Maria Grazia La; Montevecchi, Filippo; Tschabitscher, Manfred

doi:10.1002/hed.21691

Cited by 131 publications

(162 citation statements)

References 19 publications

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“…It was devised as a transoral robotic modification of Chabolle's open tongue base reduction and hyoid epiglottopexy [2]. At this time, it is estimated that more than 450 transoral robotic surgeries (TORS) for OSAHS have been performed throughout the world; 201 of them have been reported in the literature (table 1) [1,3,4,5,6,7,8]. However, there have been no multi-institutional studies examining the safety and efficacy of TORS.…”

Section: Introductionmentioning

confidence: 99%

Clinical Outcomes and Complications Associated with TORS for OSAHS: A Benchmark for Evaluating an Emerging Surgical Technology in a Targeted Application for Benign Disease

Vicini

Montevecchi

Campanini

et al. 2014

ORL

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126

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Background: The aim of this study was to create benchmarks for evaluating clinical outcomes and complications of transoral robotic surgeries (TORS) in a multicenter setting. Methods: 243 TORS for obstructive sleep apnea/hypopnea syndrome (OSAHS) operations, carried out between 2008 and 2012, were analyzed at 7 different centers. The average hospitalization was 3.5 days. The mean patient age was 50 ± 12 years, the average BMI at the time of the procedure was 28.53 ± 3.87 and the majority of the patients were men (81%). Results: The mean preoperative and postoperative apnea/hypopnea index was 43.0 ± 22.6 and 17.9 ± 18.4, respectively (p < 0.001). The mean preoperative and postoperative Epworth Sleepiness Scale score was 12.34 ± 5.19 and 5.7 ± 3.49, respectively (p < 0.001). The mean pre- and postoperative lowest O₂ saturation was 79.5 ± 8.77 and 83.9 ± 6.38%, respectively (p < 0.001). Conclusions: Patients undergoing TORS as part of a multilevel approach for the treatment of OSAHS have a reasonable expectation of success with minimal long-term morbidity.

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Section: Introductionmentioning

confidence: 99%

Clinical Outcomes and Complications Associated with TORS for OSAHS: A Benchmark for Evaluating an Emerging Surgical Technology in a Targeted Application for Benign Disease

Vicini

Montevecchi

Campanini

et al. 2014

ORL

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126

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“…Obstrüktif uyku apne sendromu hastanın yaşam kalitesini ileri derecede bozabildiği gibi hipertansiyon, miyokard enfarktü-sü ve felç için önemli bir risk faktörüdür. [1] Velofarenks, orofarenks, dil kökü, epiglot gibi birçok bölgedeki patolojiler üst solunum yolu obstrüksiyonuna yol açarak OUAS'ye neden olabilmektedir. Dil kökü seviyesindeki obstrüksiyon-lar OUAS'nin en sık görülen nedenlerindendir.…”

Section: üMraniye Eğitim Ve Araştırma Hastanesi Kulak Burun Boğaz Hasunclassified

“…Obstrüktif uyku apne sendromu cerrahisinde robotik cerrahi ise ilk olarak Vicini ve ark. [1] tarafından 2010 yılında dil köküyle ilgili patolojilerde kullanılmıştır. Aynı grup tarafından 2011 ve 2012'de daha fazla olgu içeren çalışmalar bildirilmiş, OUAS cerrahisinde dil köküne transoral robotik cerrahi (TORC) ile yaklaşımla Epworth uyku skalası, oksijen satürasyonu ve apne hipopne indeksinde istatistiksel olarak anlamlı düzelmeler görülmüştür.…”

Section: üMraniye Eğitim Ve Araştırma Hastanesi Kulak Burun Boğaz Hasunclassified

“…Aynı grup tarafından 2011 ve 2012'de daha fazla olgu içeren çalışmalar bildirilmiş, OUAS cerrahisinde dil köküne transoral robotik cerrahi (TORC) ile yaklaşımla Epworth uyku skalası, oksijen satürasyonu ve apne hipopne indeksinde istatistiksel olarak anlamlı düzelmeler görülmüştür. [1] Ayrıca bu tekniğin uygulanması sırasında kanama veya hava yolunda bozulma gibi komplikasyonlarda artış gösterilmemiştir.…”

Section: üMraniye Eğitim Ve Araştırma Hastanesi Kulak Burun Boğaz Hasunclassified

“…[5] Dil köküne bağlı OUAS'nin cerrahi tedavisinde TORC'nin kullanımı ilk olarak Vicini tarafından tanımlanmıştır. [1] Transoral robotik cerrahinin en önemli avantajı üç boyutlu görüş ve her düz-lemde doku rezeksiyonu imkanı sayılabilmesidir. Eksternal insizyon yapılmaması açık yaklaşımlara göre bir diğer avantajıdır.…”

Section: şEkil 2 Ameliyat Sırası Görüntüunclassified

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Transoral robotic surgery for sleep apnea syndrome

Oysu

Aa²,

Önder³

2014

Kulak Burun Bogaz Ihtis Derg

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Obstrüktif uyku apnesi sendromu (OUAS) başta kardiyovasküler sistem olmak üzere tüm vücut sistemlerini ve yaşam kalitesini olumsuz yönde etkileyen multisistemik bir hastalıktır. Obstrüktif uyku apnesi sendromu tedavisinde sürekli pozitif hava yolu basıncı etkin bir tedavi seçeneği olmakla birlikte, hastaların önemli bir kısmı bu tedaviyi tolere edememekte ve alternatif tedavi yöntemleri aranmaktadır. Transoral robotik lingual tonsillektomi, OUAS'li hastaların cerrahi tedavisinde yeni bir tekniktir. Bu yazıda transoral robotik lingual tonsillektomi uygulanan iki taraflı lingual tonsiller hipertrofi nedeniyle OUAS tanısı konulan 57 yaşında bir kadın olgu sunuldu. Bildiğimiz kadarıyla, bu olgu Türk tıp literatüründe bildirilmiş robotik lingual tonsillektomi uygulanan ilk OUAS olgusudur.Anahtar Sözcükler: Lingual tonsil; obstrüktif uyku apne sendromu; transoral robotik cerrahi.Obstructive sleep apnea syndrome (OSAS) is a multisystem disorder which adversely affects all body systems including cardiovascular system particularly and the quality of life. Although continuous positive airway pressure is an effective way of treatment in the treatment of OSAS, a substantial proportion of patients are not able to tolerate this treatment and seek for alternative treatment modalities. Transoral robotic lingual tonsillectomy is a novel technique for the surgical management of patients with OSAS. In this article, we report a 57-year-old female case with OSAS due to bilateral lingual tonsillar hypertrophy who underwent transoral robotic lingual tonsillectomy. To the best of our knowledge, this is the first case report of OSAS who underwent robotic lingual tonsillectomy in Turkish medical literature.

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Transoral Robotic-Assisted Lingual Tonsillectomy in the Pediatric Population

Leonardis

Duvvuri

Mehta

2013

JAMA Otolaryngol Head Neck Surg

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Transoral robotic surgery of the tongue base in obstructive sleep Apnea‐Hypopnea syndrome: Anatomic considerations and clinical experience

Abstract: Tongue base hypertrophy can be safely and effectively managed by TORS in OSAHS. Our midterm data are encouraging and worthy of further evaluation.

Cited by 131 publications

References 19 publications

Clinical Outcomes and Complications Associated with TORS for OSAHS: A Benchmark for Evaluating an Emerging Surgical Technology in a Targeted Application for Benign Disease

Clinical Outcomes and Complications Associated with TORS for OSAHS: A Benchmark for Evaluating an Emerging Surgical Technology in a Targeted Application for Benign Disease

Transoral robotic surgery for sleep apnea syndrome

Transoral Robotic-Assisted Lingual Tonsillectomy in the Pediatric Population

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