Transsubmental tongue‐base suspension in treating patients with severe obstructive sleep apnoea after failed uvulopalatopharyngoplasty: Our Experience

Huang, Tsung‐Wei; Su, Huang-Wei; Wang, Chih-Tien; Cheng, Ping‐Chia

doi:10.1111/coa.12230

Cited by 5 publications

(8 citation statements)

References 13 publications

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“…Our previous report demonstrated that TBS prevents the tongue from dropping back in a supine position. In severe OSA patients after failed UPPP, the mean reduction in AHI was 56 % (13) . After Notably, the subjective outcome of VAS of nasal obstruction during sleep was improved after surgery in the MS group, but not in the Mild group.…”

Section: Discussionmentioning

confidence: 93%

“…This work enrolled patients with more than or an equivalent of 5 events hourly on the apnea-hypopnea index (AHI). Patients with retropalatal obstruction underwent uvulopalatopharyngoplasty (UPPP), while patients with concurrent retrolingual obstruction and a Friedman palate position of grade 3 or 4 (21) underwent UPPP plus tongue base suspension (TBS) (13) . Patients with allergic rhinitis, chronic rhinitis, nasal septal deviation, sinonasal disease or tonsil sizes of grade 3 or 4 were excluded.…”

Section: Inclusion Criteriamentioning

confidence: 99%

“…The narrowed and collapsible upper airway and hypopharynx (8,9) . Successful surgical management of OSA requires various procedures to address these multiple levels of airway obstruction (10)(11)(12)(13) . Numerous observational studies have revealed a positive link between nasal obstruction and OSA (14)(15) .…”

Section: Introductionmentioning

confidence: 99%

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Reduction of postural nasal resistance following oropharyngeal surgery in patients with moderate-severe obstructive sleep apnea

Huang¹,

Cheng²,

Liao³

et al. 2020

Rhin

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Background: Patients with obstructive sleep apnea (OSA) have elevated nasopharyngeal resistances due to increased turbulent airflow. The study aims to investigate the effect of oropharyngeal surgery on nasal resistance in patients with various severity levels of OSA. Methodology: Patients with greater or equal to 5 events hourly on the apnea-hypopnea index (AHI) were enrolled. Patients with retropalatal obstruction underwent uvulopalatopharyngoplasty, while patients with concurrent retrolingual obstruction underwent uvulopalatopharyngoplasty (UPPP) plus tongue base suspension. Before surgery and after surgery, subjective outcomes were assessed using a visual analog scale (VAS), and objective outcomes were assessed using overnight polysomnography and rhinomanometry. The limitation of the study was that UPPP instead of expansion sphincter pharyngoplasty was performed in this study. Results: Sixty-two patients were enrolled, while 30 patients were diagnosed as mild OSA (group Mild) and 32 patients were moderate-severe OSA (group MS). The preoperative VAS of nasal obstruction in recumbency during sleep was significantly reduced after surgery in group MS. However, no significant differences between preoperative and postoperative VAS were found in group Mild. The postoperative anterior and posterior total nasal resistances (TNR) in sitting and supine positions were not significantly different from those before surgery in group. In contrast, the postoperative posterior TNR in supine position was 0.292±0.301(Pa/ cm 3 /s), compared with 0.425±0.343(Pa/cm 3 /s) preoperatively. Conclusions: Oropharyngeal surgery improves nasal obstruction during sleep and lowers the supine TNR measured in posterior rhinomanometry in patients with moderate-severe OSA. Oropharyngeal surgery is a possible treatment for postural nasal obstruction in patients with moderate-severe OSA.

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Section: Discussionmentioning

confidence: 93%

Section: Inclusion Criteriamentioning

confidence: 99%

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Reduction of postural nasal resistance following oropharyngeal surgery in patients with moderate-severe obstructive sleep apnea

Huang¹,

Cheng²,

Liao³

et al. 2020

Rhin

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“…TBS is a minimally invasive surgery to prevent tongue base collapse during sleep 6 . The mechanism of TBS for treating OSA is somewhat similar to that of TRD, as both therapies aim to prevent the tongue base from obstructing the airway when the genioglossus muscle becomes hypotonic during sleep.…”

Section: Discussionmentioning

confidence: 99%

“…The surgical procedure has been described previously. 6 The patients were placed in a supine position under general anesthesia with nasotracheal intubation. A 0.5-cm horizontal submental incision was made.…”

Section: Surgical Procedures Of Tbsmentioning

confidence: 99%

Predicting the Outcomes of Oropharyngeal Surgery in Patients With Obstructive Sleep Apnea Using Tongue‐Retaining Devices

Yeh,

Huang

2023

Otolaryngol.--head neck surg.

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ObjectiveTo determine the efficacy of a tongue‐retaining device (TRD) in predicting the outcomes of oropharyngeal surgery in patients with obstructive sleep apnea (OSA) before surgery.Study DesignA prospective case‐control study.SettingA single tertiary medical center.MethodsPatients with moderate‐severe OSA who underwent both uvulopalatopharyngoplasty and tongue base suspension between January 2022 and July 2022 were included. Each patient underwent a series of 3 overnight polysomnography. Objective outcomes include apnea‐hypopnea index (AHI), minimal oxygen saturation, and reduction rate of AHI. The correlation between the reduction rate of AHI with TRD and surgery was analyzed with linear regression.ResultsThe reduction rates of AHI were significantly different between the group using TRD (44 ± 24%) and the postoperative group (55 ± 21%). The cross‐tabulation revealed a strong association between a positive response to TRD treatment and a positive response to surgery. The use of TRD to evaluate surgical response demonstrated a positive predictive value of 90% and a negative predictive value of 70%. A strong correlation between the decrease in AHI was observed in both TRD and surgery groups, which was demonstrated by a steep slope in the scatter plot and a significant simple linear regression line.ConclusionPreoperative TRD response is an accurate tool for predicting the success of oropharyngeal surgery in managing OSA patients before surgical treatment. Furthermore, a quantifiable positive linear correlation exists between the efficacy of preoperative TRD treatment and surgery.

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The Role of Soft-Tissue Surgery of the Tongue in Obstructive Sleep Apnea

Beyers

Vanderveken

Heyning

et al. 2016

Curr Otorhinolaryngol Rep

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Transsubmental tongue‐base suspension in treating patients with severe obstructive sleep apnoea after failed uvulopalatopharyngoplasty: Our Experience

Cited by 5 publications

References 13 publications

Reduction of postural nasal resistance following oropharyngeal surgery in patients with moderate-severe obstructive sleep apnea

Reduction of postural nasal resistance following oropharyngeal surgery in patients with moderate-severe obstructive sleep apnea

Predicting the Outcomes of Oropharyngeal Surgery in Patients With Obstructive Sleep Apnea Using Tongue‐Retaining Devices

The Role of Soft-Tissue Surgery of the Tongue in Obstructive Sleep Apnea

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