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Predictors of success in combination of tongue base resection and lateral pharyngoplasty for obstructive sleep apnea

 Chi Sang Hwang  ;  Jin Won Kim  ;  Sang Chul Park  ;  Hyo Jin Chung  ;  Chang-Hoon Kim  ;  Joo-Heon Yoon  ;  Hyung-Ju Cho 
 European Archives of Oto-Rhino-Laryngology, Vol.274(5) : 2197-2203, 2017 
Journal Title
 European Archives of Oto-Rhino-Laryngology 
Issue Date
Adult ; Endoscopy ; Female ; Glossectomy/methods ; Humans ; Male ; Middle Aged ; Pharynx/surgery* ; Polysomnography ; Postoperative Period ; Robotic Surgical Procedures ; Sleep Apnea, Obstructive/surgery* ; Sleep, REM ; Tongue/surgery* ; Treatment Outcome
Multilevel surgery ; Obstructive sleep apnea ; Predicting factor ; Surgical outcome ; Tongue base resection
The base of the tongue has been recognized as a significant site of obstruction in patients with obstructive sleep apnea (OSA). Our aim was to determine the independent predictors of surgical success in tongue base resection combined with lateral pharyngoplasty for OSA. Thirty-one OSA patients who underwent endoscopie-guided coblator or transoral robotic tongue base resection in combination with lateral pharyngoplasty for the treatment of retroglossal obstruction between March 2012 and December 2015 were enrolled in this study. Retroglossal obstruction was identified by preoperative nasopharyngoscopy with drug-induced sleep endoscopy and/or Müller's maneuver in supine position. Patients were divided into success and failure groups according to surgical outcome (postoperative apnea-hypopnea index (AHI) less than 20 and reduction more than 50% in baseline AHI). Physical profile, polysomnography, cephalometry parameters, and drug-induced sleep endoscopy and/or Müller's maneuver findings were compared between the two groups. Tonsil grade (p = 0.002), lateral oropharyngeal wall collapse on Müller's maneuver (p = 0.002), and AHI during rapid eye movement (REM AHI) (p = 0.038) were significantly higher in the success group than in the failure group. Tongue base collapse was more evident in the failure group than in the success group when patients open their mouth. (p = 0.037) Bigger tonsil size and higher REM AHI are favorable predictive factors, even in multilevel surgery such as tongue base resection, whereas tongue base collapse during mouth opening may be an unfavorable predictive factor.
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1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Chang Hoon(김창훈) ORCID logo https://orcid.org/0000-0003-1238-6396
Park, Sang Chul(박상철)
Yoon, Joo Heon(윤주헌)
Cho, Hyung Ju(조형주) ORCID logo https://orcid.org/0000-0002-2851-3225
Hwang, Chi Sang(황치상)
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