Use of the transoral robotic surgery to treat patients with recurrent lingual tonsillitis

Luca, Milena Di; Iannella, Giannicola; Montevecchi, Filippo; Magliulo, Giuseppe; Vito, Andrea De; Cocuzza, Salvatore; Maniaci, Antonino; Meccariello, Giuseppe; Cammaroto, Giovanni; Sgarzani, Rossella; Ferlito, S; Vicini, Claudio

doi:10.1002/rcs.2106

Cited by 30 publications

(31 citation statements)

References 32 publications

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“…Further clinical investigation will be needed to clarify the aging effect on swallowing in the growing patients with mandibular protrusion. Moreover, various comorbidities such as anomalous cervical carotid artery pathway [ 16 ], hypertrophy of the lingual tonsil [ 17 ], aneurysmal bone cyst [ 18 ] can influence changes in tongue-palatal contact during swallowing. We will try to investigate tongue-palatal contact patterns in patients with dysphagia due to such diseases using EPG in future.…”

Section: Discussionmentioning

confidence: 99%

Changes in tongue–palatal contact during swallowing in patients with skeletal mandibular prognathism after orthognathic surgery

et al. 2021

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This study aimed to evaluate improvement of tongue-palatal contact patterns during swallowing after orthognathic surgery in mandibular prognathism patients. Thirty patients with mandibular prognathism treated by orthognathic surgery (average age of 27 years, 3 months) and 10 controls (average age 29 years, 6 months) participated in this study. Tongue-palatal contact patterns of patients before and three months after surgery were evaluated by electropalatography (EPG) as well as controls. Whole total of tongue-palatal contact at 0.3, 0.2, and 0.1 sec before complete tongue-palatal contact during swallowing were evaluated. The duration of swallowing phases was also examined. Complete contact of tongue-tip in the alveolar part of individual artificial EPG plate were shown at 0.3, 0.2, and 0.1 sec before complete tongue-palatal contact in the controls, although incomplete contact in the alveolar part were shown at 0.3 sec in mandibular prognathism patients. Whole total of tongue-palatal contact at 0.3 and 0.2 sec before complete tongue-palatal contact was significantly lower in the patients before surgery than in the controls (p<0.05). However, these values increased after surgery. The duration of oral and pharyngeal phase was significantly longer in the patients before surgery than in the controls and the patients after surgery (p<0.01). This study demonstrated that the tongue-palatal contact pattern improved and the duration of oral and pharyngeal phase was shortened in mandibular prognathism patients during swallowing after orthognathic surgery. It is suggested that changes in maxillofacial morphology by orthognathic surgery can induce normal tongue movement during swallowing. (The data underlying this study have been uploaded to figshare and are accessible using the following DOI: https://doi.org/10.6084/m9.figshare.14101616.v1)

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Section: Discussionmentioning

confidence: 99%

Changes in tongue–palatal contact during swallowing in patients with skeletal mandibular prognathism after orthognathic surgery

et al. 2021

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“…Transoral robotic surgery (TORS) is a novel surgical technique for OSA patients and provides a visual assistant in targeted tissue operation for surgeons [ 10 ]. In addition, it also provides access to the retrolingual area, allowing the removal of the results of recurrent lingual tonsillitis, which, in patients who previously underwent tonsillectomies, can considerably reduce the air space [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

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

Tsou

Hsu

Shih

et al. 2021

JCM

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Background: Successful surgery outcomes are limited to moderate to severe obstructive sleep apnea (OSA) syndrome. Multilevel collapse at retropalatal and retroglossal areas is often found during the drug-induced sleep endoscopy (DISE). Therefore, multilevel surgery is considered for these patients. The aim of our study was to survey surgical outcomes by modified uvulopalatoplasty (UPPP) plus transoral robotic surgery tongue base reduction (TORSTBR) versus barbed repositioning pharyngoplasty (BRP) plus TORSTBR. Methods: The retrospective cohort study was performed at a tertiary referral center. We collected moderate to severe OSA patients who were not tolerant to positive pressure assistant PAP from September 2016 to September 2019; pre-operative–operative Muller tests all showed retropalatal and retroglossal collapse; pre-operative Friedman Tongue Position (FTP) > III, with the tonsils grade at grade II minimum, with simultaneous velum (V > 1) and tongue base (T > 1), collapsed by drug-induced sleep endoscopy (DISE) under the VOTE grading system. The UPPP plus TORSTBR (n = 31) and BRP plus TORSTBR (n = 31) techniques were offered. We compare the outcomes using an Epworth sleepiness scale (ESS) questionnaire, and measure the patients’ apnea–hypopnea index (AHI), lowest O2 saturation, cumulative time spent below 90% (CT90), and arousal index (AI) by polysomnography six months after surgery; we also measure their length of hospital stay and complications between these two groups. Results: Comparing BRP plus TORSTBR with UPPP plus TORSTBR, the surgical success rate is 67.74% and 38.71%, respectively. The significantly higher surgical success rate in the BRP plus TORSTBR group was noted. The surgical time is shorter in the BRP plus TORSTBR group. The complication rate is not significant in pain, bleeding, dysgeusia, dysphagia, globus sensation, and prolonged suture stay, even though the BRP plus TORSTBR rendered a higher percentage of globus sensation during swallowing and a more prevalent requirement of suture removal one month after surgery. The length of hospital stay is not significantly different between the two groups. Conclusion: In conclusion, BRP plus TORSTBR is a considerable therapy for moderate to severe OSA patients with DISE showing a multi-level collapse in velum and tongue base area. The BRP technique might offer a better anterior–posterior suspension vector for palate level obstruction.

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“…Tonsillectomy is a common surgical intervention (1)(2)(3). It involves the complete or partial removal of the palatine tonsils primarily to prevent recurring infections and inflammation (4,5). However, the surgical site is a highly vascularized zone and complications are frequent due to unintended trauma during the procedure (6,7).…”

Section: Introductionmentioning

confidence: 99%

Efficacy of bupivacaine infiltration for controlling post‑tonsillectomy pain, duration of surgery and post‑operative morbidities: A systematic review and meta‑analysis

Wang

Gong

2021

Exp Ther Med

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Use of the transoral robotic surgery to treat patients with recurrent lingual tonsillitis

Cited by 30 publications

References 32 publications

Changes in tongue–palatal contact during swallowing in patients with skeletal mandibular prognathism after orthognathic surgery

Changes in tongue–palatal contact during swallowing in patients with skeletal mandibular prognathism after orthognathic surgery

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

Efficacy of bupivacaine infiltration for controlling post‑tonsillectomy pain, duration of surgery and post‑operative morbidities: A systematic review and meta‑analysis

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