Patient centered outcomes of transoral robotic surgery for obstructive sleep apnea: a retrospective analysis.

IF 1.9 3区 医学 Q2 OTORHINOLARYNGOLOGY
Alexandra G L Toppenberg, Wouter L Lodder, Robert E Plaat, Leonora Q Schwandt
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引用次数: 0

Abstract

Purpose: Obstructive Sleep Apnea (OSA) is usually caused by collapse of the base of tongue (BOT) and impacts patients' overall health. Despite current conventional therapies, some patients do not achieve satisfactory results. Reduction of BOT using Trans Oral Robotic Surgery (TORS) emerges as a promising treatment. We evaluated the patient reported and clinical outcomes of TORS for OSA.

Methods: We performed a retrospective cohort study of patients treated from 2018 to 2021 in a non-academic general hospital. Patients were eligible for TORS when apnea hypopnea index (AHI) was >5 in combination with obstruction at BOT level. Patients were included when 1-year follow up respiratory polygraphy was available. Changes in Epworth Sleepiness Scale (ESS), Functional Outcomes of Sleep Questionnaire (FOSQ-35), MD Anderson Dysphagia Inventory (MDADI) scores and postoperative complications were evaluated. Surgical success rates were obtained.

Results: Out of 56 patients, 28 patients of which 22 (78.6%) males and 6 (21.4%) females, with OSA severity ranging from mild to severe and mean age of 49 (SD 11.8) with a median BMI of 28.1 (IQR 26.9-32.1) were included. ESS score declined from mean 5.9 (SD 3.8) to 2.2 (SD 2.0) (p<0.00). FOSQ-35 scores were all declined (p<0.05). MDADI scores were in normal range (80-100) and remained stable (p = 0.44). In 23 (82.1%) patients no postoperative complications were observed. Surgical success rates were 86%.

Conclusions: TORS demonstrate to be effective and safe in OSA patients, and it can be used in both patients who are unresponsive to conventional therapies or as a primary therapy.

以患者为中心的经口机器人手术治疗阻塞性睡眠呼吸暂停:回顾性分析。
目的:阻塞性睡眠呼吸暂停(OSA)通常由舌根塌陷(BOT)引起,影响患者的整体健康。尽管目前的常规治疗,一些患者没有达到令人满意的结果。使用经口机器人手术(TORS)减少BOT是一种很有前途的治疗方法。我们评估了患者报告和TORS治疗OSA的临床结果。方法:我们对2018年至2021年在一家非学术综合医院接受治疗的患者进行了回顾性队列研究。当呼吸暂停低通气指数(AHI)为bb0.5并伴有BOT水平阻塞时,患者符合TORS的条件。患者纳入1年随访呼吸测谎术。评估Epworth嗜睡量表(ESS)、睡眠功能结局问卷(FOSQ-35)、MD Anderson吞咽困难量表(MDADI)评分及术后并发症的变化。获得手术成功率。结果:共纳入56例患者,其中男性22例(78.6%),女性6例(21.4%),OSA严重程度轻至重度,平均年龄49岁(SD 11.8),中位BMI为28.1 (IQR 26.9-32.1)。ESS评分从平均5.9分(SD 3.8)降至2.2分(SD 2.0)。结论:TORS对OSA患者有效且安全,既可用于对常规治疗无反应的患者,也可作为主要治疗方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.30
自引率
7.70%
发文量
537
审稿时长
2-4 weeks
期刊介绍: Official Journal of European Union of Medical Specialists – ORL Section and Board Official Journal of Confederation of European Oto-Rhino-Laryngology Head and Neck Surgery "European Archives of Oto-Rhino-Laryngology" publishes original clinical reports and clinically relevant experimental studies, as well as short communications presenting new results of special interest. With peer review by a respected international editorial board and prompt English-language publication, the journal provides rapid dissemination of information by authors from around the world. This particular feature makes it the journal of choice for readers who want to be informed about the continuing state of the art concerning basic sciences and the diagnosis and management of diseases of the head and neck on an international level. European Archives of Oto-Rhino-Laryngology was founded in 1864 as "Archiv für Ohrenheilkunde" by A. von Tröltsch, A. Politzer and H. Schwartze.
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