State of the art transoral robotic surgery for obstructive sleep apnea-hypopnea syndrome.

摘要: Objective To review the existing literature on role of transoral robotic surgery (TORS) for tongue base reduction in management adult obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods We searched PubMed, MEDLINE, and Scopus databases from first report this surgical technique to July 30, 2015 studies investigating use TORS treating OSAHS. Our primary outcome measures were Apnea- Hypopnea Index (AHI), lowest oxygen saturation (LSAT), Epworth Sleepiness Score (ESS), rates cure (AHI<5) success (50% AHI accompanied by a postoperative AHI<20). secondary volume tissue resected correlation AHI, polysomnographic parameters, subjective outcomes, body mass index. Complications also analyzed. Results Thirteen articles critically evaluated research. However, only four case series qualified statistical analysis outcomes six complications. They with total 451 patients. Pooled revealed statistically significant improvements LSAT, ESS after 26.83/hour, 5.28% -8.03, respectively. The average 23.8% 66.7%, No study reported any deaths or complications related equipment. major complication rate was 6.9%, minor 30.0%. Major included bleeding (2.9%), severe odynophagia dehydration (3.3%), oropharyngeal stenosis (0.7%). Minor transient (0.5%), dysphagia (3.8%), dysgeusia (6.6%). Conclusion reduction, as component multilevel surgery, is an effective treatment option OSAHS acceptable morbidity. This conclusion based results multiple series. Future should entail prospective randomized controlled trials larger sample size longer follow-up period.