Outcomes for multilevel surgery for sleep apnea: Obstructive sleep apnea, transoral robotic surgery, and uvulopalatopharyngoplasty

摘要: Objectives/Hypothesis This study evaluates the outcomes of multilevel surgery for patients with obstructive sleep apnea (OSA) who underwent transoral robotic (TORS) (i.e., posterior glossectomy and limited lateral pharyngectomy) uvulopalatopharyngoplasty (UPPP). Study Design Prospective, nonrandomized trial historical controls. Methods All pre- postoperative polysomnography, preoperative magnetic resonance imaging neck, drug-induced endoscopy, surgery, including UPPP if this had not occurred previously, OSA TORS. Outcomes measures included apnea-hypopnea index (AHI), Epworth Sleepiness Scale (ESS), O2 saturation nadir, total time spent at <90% saturation. Results Patients no prior achieved an average AHI reduction from 58.4 to 19.5 (67%, P < .0001), a surgical success rate 56%, response 73%. Patients pharyngeal 55.0 45 (24%, P = .19), 30%, 40%. Total was improved 14% 3.6% (P < .0003) without 21.1% 12.5% (P < .17)for those surgery. ESS all combined 12.8 5.8 (P < .0001). Conclusions Outcomes approach TORS provide strong evidence in favor management OSA. The benefit current is most significant previously unoperated patients. Level Evidence 4. Laryngoscope, 126:266–269, 2016