Quality of Life and Sleep Outcomes in Obstructive Sleep Apnoea Following Transoral Robotic Surgery: A Meta-Analysis

IF 1.5 4区医学 Q2 OTORHINOLARYNGOLOGY

Clinical Otolaryngology Pub Date : 2025-04-02 DOI:10.1111/coa.14311

Keshav Kumar Gupta, Mriganka De, Thanos Athanasiou, Christos Georgalas, George Garas

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引用次数: 0

Abstract

Objective

Obstructive sleep apnoea (OSA) can have a significant health burden in terms of sleep outcomes, systemic morbidity including cardiovascular and urological complications, and quality of life (QoL). Transoral robotic surgery (TORS) constitutes a novel option for patients where continuous positive airway pressure (CPAP) is not tolerated. This study aimed to assess OSA patients managed with TORS in terms of QoL and sleep outcomes.

Data Sources

Systematic review using EMBASE, CINAHL, MEDLINE, and Cochrane electronic databases.

Review Methods

Studies were identified assessing QoL (with validated QoL tools) and sleep outcomes in OSA patients managed with TORS. For the meta-analysis, mean difference (MD) was calculated using an inverse variance random-effects model.

Results

Four studies (252 patients) were included. Meta-analysis showed improvements in apnoea-hypopnea index (AHI) (MD = 20.01, p < 0.00001), Epworth Sleepiness Scale (ESS) (MD = 5.16, p < 0.00001) and lowest oxygen saturations (LSaO₂) (MD = -7.05, p < 0.00001) following TORS. For QoL, there were improvements in voice, prostate and overactive bladder symptoms, erectile function, and overall QoL following TORS. Swallowing returned to baseline at 3 months. No major complications were reported, with all adverse events managed conservatively.

Conclusion

This systematic review and meta-analysis is the first in the existing literature to evaluate TORS as a treatment option for OSA across both sleep and QoL domains. Significant improvements were observed in both parameters following TORS. Whilst further research is needed, the current findings can assist clinicians and patients when it comes to clinical decision-making regarding personalised treatment options for a condition that carries a significant morbidity and QoL burden.

Trial Registration: PROSPERO: CRD42024448926

查看原文本刊更多论文

经口机器人手术后阻塞性睡眠呼吸暂停患者的生活质量和睡眠结局：一项荟萃分析。

目的：阻塞性睡眠呼吸暂停（OSA）在睡眠结局、全身发病率（包括心血管和泌尿系统并发症）和生活质量（QoL）方面具有显著的健康负担。经口机器人手术（TORS）为不耐受持续气道正压（CPAP）的患者提供了一种新的选择。本研究旨在评估接受TORS治疗的OSA患者的生活质量和睡眠结果。数据来源：系统评价使用EMBASE， CINAHL， MEDLINE和Cochrane电子数据库。回顾方法：研究评估了接受TORS治疗的OSA患者的生活质量（使用经过验证的生活质量工具）和睡眠结果。对于meta分析，使用逆方差随机效应模型计算平均差异（MD）。结果：纳入4项研究（252例患者）。荟萃分析显示，呼吸暂停低通气指数（AHI）（MD = 20.01, p 2）（MD = -7.05, p）有所改善。结论：本系统综述和荟萃分析是现有文献中首次在睡眠和生活质量领域评估TORS作为OSA治疗选择。在TORS之后，这两个参数都有了显著的改善。虽然需要进一步的研究，但目前的研究结果可以帮助临床医生和患者在临床决策时选择个性化的治疗方案，以应对具有显著发病率和生活质量负担的疾病。试验注册：PROSPERO: CRD42024448926。

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

Clinical Otolaryngology 医学-耳鼻喉科学

CiteScore

4.00

自引率

4.80%

发文量

106

审稿时长

>12 weeks

期刊介绍： Clinical Otolaryngology is a bimonthly journal devoted to clinically-oriented research papers of the highest scientific standards dealing with: current otorhinolaryngological practice audiology, otology, balance, rhinology, larynx, voice and paediatric ORL head and neck oncology head and neck plastic and reconstructive surgery continuing medical education and ORL training The emphasis is on high quality new work in the clinical field and on fresh, original research. Each issue begins with an editorial expressing the personal opinions of an individual with a particular knowledge of a chosen subject. The main body of each issue is then devoted to original papers carrying important results for those working in the field. In addition, topical review articles are published discussing a particular subject in depth, including not only the opinions of the author but also any controversies surrounding the subject. • Negative/null results In order for research to advance, negative results, which often make a valuable contribution to the field, should be published. However, articles containing negative or null results are frequently not considered for publication or rejected by journals. We welcome papers of this kind, where appropriate and valid power calculations are included that give confidence that a negative result can be relied upon.